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NPI Code Detail

MEDICARE: KIMBERLY WELCH

MEDICARE: KIMBERLY WELCH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1083129506
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY WELCH
Provider Business Mailing Address
First Line : 147 ROSEMARY LN
Second Line :
City : STONEWALL
State : LA
Zip : 71078-9309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2350 LEVY ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71103-3656
Country : US
Telephone Number : 318-317-3782
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2017
Last Update Date : 11/16/2023

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Directions to “ KIMBERLY WELCH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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