Provider Demographics
NPI:1487238424
Name:WELTY, CARRIE ANN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:WELTY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 DAVENPORT RD
Mailing Address - Street 2:
Mailing Address - City:BIG FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:14814-9762
Mailing Address - Country:US
Mailing Address - Phone:607-742-9664
Mailing Address - Fax:
Practice Address - Street 1:161 OAKWOOD AVE STE C
Practice Address - Street 2:
Practice Address - City:ELMIRA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:14903-1648
Practice Address - Country:US
Practice Address - Phone:607-247-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030676-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist