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Individual

MRS. REBECCA J WELBORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LACA, BSADC,CAPRC II

Contact information

Practice address
704 N STATE ST STE A, GREENFIELD, IN 46140-3616
(317) 406-8191
Mailing address
304 S JEFFERSON ST, KNIGHTSTOWN, IN 46148-1326
(317) 318-4802

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
99128120A
IN
172V00000X
Community Health Worker
IN
175T00000X
Peer Specialist
CAPRC2-5198
IN

Other

Enumeration date
08/24/2023
Last updated
11/17/2024
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