Provider Demographics
NPI:1801789730
Name:WELCH, ZOWIE RAITT
Entity type:Individual
Prefix:
First Name:ZOWIE
Middle Name:RAITT
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45307 HARDESTY RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-9688
Mailing Address - Country:US
Mailing Address - Phone:405-240-1514
Mailing Address - Fax:
Practice Address - Street 1:45307 HARDESTY RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-9688
Practice Address - Country:US
Practice Address - Phone:405-240-1514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician