Healthcare Provider Details

I. General information

NPI: 1649182700
Provider Name (Legal Business Name): JILL ANN WELAGE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNIE WELAGE

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 W TRUESDELL ST
WILMINGTON OH
45177-2591
US

IV. Provider business mailing address

4500 CEDAR HILL DR
BATAVIA OH
45103-1256
US

V. Phone/Fax

Practice location:
  • Phone: 937-382-2750
  • Fax:
Mailing address:
  • Phone: 513-340-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number16966
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: