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General NPI Number Information
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NPI Number | 1871303800
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Entity Type | Individual
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Provider Name | AUTUMN A. WELCH
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Gender | Female
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Dates
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Enumeration Date | 01/11/2025
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Last Update Date | 01/11/2025
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Provider Practice Location Address
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Address Line | 10781 E CHERRY BEND RD # STUDIO10
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-5249
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Country | US
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Telephone | 231-268-0007
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Fax |
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Provider Business Mailing Address
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Address Line | 1727 KETTLE LAKE RD NE
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City | KALKASKA
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State | MI
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Zip | 49646-9647
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Country | US
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Telephone | 231-564-8032
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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