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General NPI Number Information
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NPI Number | 1053850289
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Entity Type | Individual
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Provider Name | KATHRYN JANE WELTE M.A., CCC, SLP, BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/21/2017
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 28101 COOKSTOWN CT UNIT 4402
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-8796
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Country | US
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Telephone | 201-707-9587
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Fax |
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Provider Business Mailing Address
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Address Line | 28101 COOKSTOWN CT UNIT 4402 UNIT 4402
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-8797
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Country | US
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Telephone | 201-707-9587
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA 15068
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | SA 15068
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License Number State | FL
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