Healthcare Provider Details

I. General information

NPI: 1316862964
Provider Name (Legal Business Name): REAGAN HELMKE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N MILLER DR
SUNBURY OH
43074-7667
US

IV. Provider business mailing address

12835 WOODTOWN RD
GALENA OH
43021-9476
US

V. Phone/Fax

Practice location:
  • Phone: 740-965-7850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND.20263609-SP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: