Individual
BREANNE NICHOLE WELTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 E CONGRESS PKWY, SUITE B, CRYSTAL LAKE, IL 60014-6247
(815) 459-3810
(815) 356-3550
Mailing address
411 E CONGRESS PKWY, SUITE B, CRYSTAL LAKE, IL 60014-6247
(815) 459-3810
(815) 356-3550
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.009470
IL
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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