Healthcare Provider Details

I. General information

NPI: 1194040162
Provider Name (Legal Business Name): HELCIA HELEN VASCONCELLOS L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N WASHINGTON ST
FALLS CHURCH VA
22046-4518
US

IV. Provider business mailing address

PO BOX 40052
WASHINGTON DC
20016-0052
US

V. Phone/Fax

Practice location:
  • Phone: 703-531-1780
  • Fax:
Mailing address:
  • Phone: 617-997-7342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121000678
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: