Provider Demographics
NPI:1578386439
Name:WELCH, CINDY A (RD)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:A
Last Name:WELCH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UPLAND CT
Mailing Address - Street 2:
Mailing Address - City:COLGATE
Mailing Address - State:WI
Mailing Address - Zip Code:53017-9735
Mailing Address - Country:US
Mailing Address - Phone:760-580-7321
Mailing Address - Fax:
Practice Address - Street 1:N82W15845
Practice Address - Street 2:APPLETON AVE.
Practice Address - City:MENOMONEE FALLS FALLS WI
Practice Address - State:WI
Practice Address - Zip Code:53051
Practice Address - Country:US
Practice Address - Phone:262-251-2929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA859799133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered