Doctor Name: | ENRICO THOMAS WELSCH |
NPI Number: | 1124475785 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | 12122 |
Business Practice Address: | 624 13th St S Virginia, MN - 557923149 |
Business Phone Number: | 2187492881 |
Business Fax Number: | 2187493806 |
Mailing Address: | 624 13th St S, Po Box 1188 VIRGINIA |
State: | MN |
Postal Code: | 557923149 |
Phone Number: | 2187492881 |
Fax Number: | 2187493806 |
NPI Enumeration Date: | 05/24/2016 |
NPI Last Update Date: | 05/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 12122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |