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Individual

CHESTER ORLAND WELCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
927 TRETTEL LN, FOND DU LAC HUMAN SERVICES DIVISION, CLOQUET, MN 55720-1345
(218) 879-1227
(218) 878-2188
Mailing address
20 BURGER DR, DULUTH, MN 55808-1922
(218) 626-2395

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300211
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NPP000
FDLHSD UPIN
MN
Enumeration date
01/17/2007
Last updated
07/08/2007
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