Basic Information
Provider Information
NPI: 1861445207
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROYAL
FirstName: HELEN
MiddleName: Q
NamePrefix:  
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 40
Address2:  
City: GLENWOOD SPRINGS
State: CO
PostalCode: 816020040
CountryCode: US
TelephoneNumber: 9709452241
FaxNumber: 9709455523
Practice Location
Address1: 360 PEAK ONE DR
Address2: SUITE 110
City: FRISCO
State: CO
PostalCode: 80443
CountryCode: US
TelephoneNumber: 9706683478
FaxNumber: 9706680632
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 04/28/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2403COY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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