Healthcare Provider Details
I. General information
NPI: 1003870940
Provider Name (Legal Business Name): BARBARA BREWER WELSCH DVM, PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 FLETCHER DR. SHCC
GAINESVILLE FL
32611-7500
US
IV. Provider business mailing address
1 FLETCHER DR SHCC
GAINESVILLE FL
32611-7500
US
V. Phone/Fax
- Phone: 352-392-1171
- Fax: 352-392-1433
- Phone: 352-392-1171
- Fax: 352-392-1433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PY6223 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: