MEDICARE: HEATHER WELLING SLP

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
1	235Z00000X	Speech-Language Pathologist	SP8354	OH

General Provider Information

NPI Number	:	1629449657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER WELLING SLP

Provider Business Mailing Address
First Line	:	3731 PAULA DR
Second Line	:
City	:	RICHFIELD
State	:	OH
Zip	:	44286-9725
Country	:	US
Telephone Number	:	216-223-8761
Fax Number	:	309-423-4813

Provider Business Practice Location Address
First Line	:	5247 WILSON MILLS RD # 126
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-3016
Country	:	US
Telephone Number	:	216-223-8761
Fax Number	:	309-423-4813

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2015
Last Update Date	:	10/16/2015

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Directions to “ HEATHER WELLING SLP” Practice Location

Language	Start Address	Practice Location

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