Basic Information
| Provider Information | |||||||||
| NPI: | 1750505624 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WELDY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 211354 | ||||||||
| Address2: | |||||||||
| City: | AUKE BAY | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998211354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075239763 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3245 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998017809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073644445 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 234 | AK | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.