Healthcare Provider Details

I. General information

NPI: 1285304279
Provider Name (Legal Business Name): REBECCA HELMEID MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 09/20/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1537 HERITAGE BLVD
WEST SALEM WI
54669-9404
US

IV. Provider business mailing address

1908 COMMERCIAL ST APT 201
BANGOR WI
54614-1802
US

V. Phone/Fax

Practice location:
  • Phone: 608-304-7279
  • Fax:
Mailing address:
  • Phone: 630-945-0776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number16669
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: