Basic Information
Provider Information
NPI: 1801922075
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HELMS
FirstName: ANNALEA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: M.A., C.C.C.-S.L.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2087 BRITTANY CT
Address2:  
City: SHAKOPEE
State: MN
PostalCode: 553794388
CountryCode: US
TelephoneNumber: 9522334153
FaxNumber:  
Practice Location
Address1: 333 SMITH AVE N
Address2:  
City: SAINT PAUL
State: MN
PostalCode: 551022344
CountryCode: US
TelephoneNumber: 6512417238
FaxNumber: 6512417177
Other Information
ProviderEnumerationDate: 02/24/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X5664MNY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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