Healthcare Provider Details

I. General information

NPI: 1265411557
Provider Name (Legal Business Name): FREDIA J HELBERT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 COEBURN AVE SW
NORTON VA
24273-2606
US

IV. Provider business mailing address

338 COEBURN AVE SW
NORTON VA
24273-2606
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-4114
  • Fax: 276-679-2174
Mailing address:
  • Phone: 276-679-4114
  • Fax: 276-679-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2201000226
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: