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NPI Code Detail

MEDICARE: MS. KATHRYN JANE WELTE M.A., CCC, SLP, BCBA

MEDICARE:  MS. KATHRYN JANE WELTE  M.A., CCC, SLP, BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 15068FL
2222Q00000XDevelopmental TherapistSA 15068FL

General Provider Information

NPI Number : 1053850289
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHRYN JANE WELTE M.A., CCC, SLP, BCBA
Provider Business Mailing Address
First Line : 28101 COOKSTOWN CT UNIT 4402
Second Line : UNIT 4402
City : BONITA SPRINGS
State : FL
Zip : 34135-8797
Country : US
Telephone Number : 201-707-9587
Fax Number :
Provider Business Practice Location Address
First Line : 28101 COOKSTOWN CT
Second Line : UNIT 4402
City : BONITA SPRINGS
State : FL
Zip : 34135-8796
Country : US
Telephone Number : 201-707-9587
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2017
Last Update Date : 02/21/2017

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Directions to “ MS. KATHRYN JANE WELTE M.A., CCC, SLP, BCBA” Practice Location

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