| Doctor Name: | SUSAN BULL-WELCH |
| NPI Number: | 1497864334 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | |
| Business Practice Address: | 1314 10th St Silvis, IL - 612821892 |
| Business Phone Number: | 3097926563 |
| Business Fax Number: | 3097926430 |
| Mailing Address: | 2100 52nd Ave, MOLINE |
| State: | IL |
| Postal Code: | 612656366 |
| Phone Number: | 3097972900 |
| Fax Number: | 3097972147 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 11/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |