Provider Demographics
NPI:1972627487
Name:WELSH, KIM R (AUD, F-AAA, CCC-A)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:R
Last Name:WELSH
Suffix:
Gender:F
Credentials:AUD, F-AAA, 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:PO BOX 9190
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80932-0190
Mailing Address - Country:US
Mailing Address - Phone:719-867-7800
Mailing Address - Fax:719-867-7899
Practice Address - Street 1:6071 E WOODMEN RD
Practice Address - Street 2:STE 325
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2607
Practice Address - Country:US
Practice Address - Phone:719-867-7800
Practice Address - Fax:719-867-7899
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0000102237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO300198Medicare PIN
CO62538870Medicaid