Provider Demographics
NPI:1194887737
Name:WELSH, JAMES JOHN (MA, CCC-A)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JOHN
Last Name:WELSH
Suffix:
Gender:M
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 S BEECHTREE ST
Mailing Address - Street 2:
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1603
Mailing Address - Country:US
Mailing Address - Phone:616-607-2698
Mailing Address - Fax:
Practice Address - Street 1:17 S BEECHTREE ST
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1603
Practice Address - Country:US
Practice Address - Phone:616-607-2698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000162231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist