Provider Demographics
NPI:1497938237
Name:WELTZIN-TRAINER, VICKI
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:WELTZIN-TRAINER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:L
Other - Last Name:TRAINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6143 N ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-2769
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 W 53RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-2401
Practice Address - Country:US
Practice Address - Phone:563-391-5342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-16
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist