MEDICARE: DR. FONYA HELM PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1008	MD
2	103TC0700X	Clinical Psychologist	755	DC
3	103TC0700X	Clinical Psychologist	002446	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1GG93	OTHER	MD	BLUECROSSBLUESHIELD

General Provider Information

NPI Number	:	1083831218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FONYA HELM PH.D.

Provider Business Mailing Address
First Line	:	8000 RIVERSIDE AVE
Second Line	:
City	:	CABIN JOHN
State	:	MD
Zip	:	20818-1627
Country	:	US
Telephone Number	:	301-229-9120
Fax Number	:	310-229-7239

Provider Business Practice Location Address
First Line	:	8000 RIVERSIDE AVE
Second Line	:
City	:	CABIN JOHN
State	:	MD
Zip	:	20818-1627
Country	:	US
Telephone Number	:	301-229-9120
Fax Number	:	310-229-7239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. FONYA HELM PH.D.” Practice Location

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