MEDICARE: DR. BARBARA CLEMENTS HELLER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH67	FL
2	103TS0200X	School Psychologist	SS23	FL
3	106H00000X	Marriage & Family Therapist	MT56	FL

General Provider Information

NPI Number	:	1073556585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA CLEMENTS HELLER PHD

Provider Business Mailing Address
First Line	:	631 PALM SPRINGS DR
Second Line	:	SUITE 101
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-7854
Country	:	US
Telephone Number	:	407-331-1121
Fax Number	:	407-331-1156

Provider Business Practice Location Address
First Line	:	631 PALM SPRINGS DR
Second Line	:	SUITE 101
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-7854
Country	:	US
Telephone Number	:	407-331-1121
Fax Number	:	407-331-1156

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	08/17/2007

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