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NPI Code Detail

MEDICARE: ANYA HELGESON

MEDICARE: ANYA HELGESON
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
1252Y00000XEarly Intervention Provider Agency
2222Q00000XDevelopmental TherapistAH05100316PIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AH05100316POTHERILPROVIDER CONNECTIONS

General Provider Information

NPI Number : 1164879326
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANYA HELGESON
Provider Business Mailing Address
First Line : 4637 COLUMBUS AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-3527
Country : US
Telephone Number : 612-803-9979
Fax Number :
Provider Business Practice Location Address
First Line : 3501 ALDRICH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-4149
Country : US
Telephone Number : 612-430-2635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2016
Last Update Date : 09/28/2021

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