Healthcare Provider Details
I. General information
NPI: 1720145642
Provider Name (Legal Business Name): MARY M HELWIG MA, AUD, CCCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1425 S MAIN ST
WALNUT CREEK CA
94596-5318
US
IV. Provider business mailing address
1351 SWALLOWTAIL RD
CONCORD CA
94521-4348
US
V. Phone/Fax
- Phone: 925-295-4991
- Fax: 925-295-5414
- Phone: 925-349-6754
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | AU 721 AND HA1495 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: