Healthcare Provider Details

I. General information

NPI: 1912818915
Provider Name (Legal Business Name): INDYA ROBINSON WELCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INDYA SHANTEL ROBINSON

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 RAM DR
COVINGTON GA
30014-1958
US

IV. Provider business mailing address

51 CARNABY ST
WINDER GA
30680-4375
US

V. Phone/Fax

Practice location:
  • Phone: 770-784-2928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA000559
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: