Healthcare Provider Details

I. General information

NPI: 1376316976
Provider Name (Legal Business Name): SVETLANA HELLER CNT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9085 E MINERAL CIR STE 255
CENTENNIAL CO
80112-3411
US

IV. Provider business mailing address

50 FALCON HILLS DR
HIGHLANDS RANCH CO
80126-2901
US

V. Phone/Fax

Practice location:
  • Phone: 303-933-3479
  • Fax:
Mailing address:
  • Phone: 720-341-5943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: