Most Relevant Information
Provider Data
| NPI Number: | 1003415076 |
| Provider Name: | ROBERTA LEIGH WELCH LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | SW17584 |
Most Important Dates
| Enumeration Date: | 10/21/2020 |
| Last Updated: | 10/21/2020 |
Provider Practice Location
137 HOSPITAL DR NE
FORT WALTON BEACH
FL
325485015
Practice Location Phone/Fax
| Phone: | 8508337500 |
| Fax: |
Provider Mailing Location
8517 HIGH SCHOOL BLVD
NAVARRE
FL
325663220
Provider Mailing Phone/Fax
| Phone: | 8507763631 |
| Fax: |