Healthcare Provider Details

I. General information

NPI: 1538832159
Provider Name (Legal Business Name): COURTNEY V HELTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 07/29/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2631 RT 34
WINFIELD WV
25213
US

IV. Provider business mailing address

PO BOX 427
SCOTT DEPOT WV
25560-0427
US

V. Phone/Fax

Practice location:
  • Phone: 681-234-3114
  • Fax: 866-332-2962
Mailing address:
  • Phone: 681-235-3114
  • Fax: 866-332-2962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: