Healthcare Provider Details

I. General information

NPI: 1073677910
Provider Name (Legal Business Name): DR. HELEN CHILDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 GUADALUPE ST
AUSTIN TX
78751-4223
US

IV. Provider business mailing address

4110 GUADALUPE ST
AUSTIN TX
78751-4223
US

V. Phone/Fax

Practice location:
  • Phone: 512-452-0381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number25815
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: