Basic Information
| Provider Information | |||||||||
| NPI: | 1538754734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICHARDSON | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | G | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3704 MIZELL RD APT J | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274054711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9803287333 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1018 N BRAGG BLVD | ||||||||
| Address2: | |||||||||
| City: | SPRING LAKE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283903316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102952690 | ||||||||
| FaxNumber: | 9102950026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2021 | ||||||||
| LastUpdateDate: | 03/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.