MEDICARE: MR. BRETT ASHLEY HELMER OT

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	225X00000X	Occupational Therapist	3894	CT

General Provider Information

NPI Number	:	1285706135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRETT ASHLEY HELMER OT

Provider Business Mailing Address
First Line	:	85 CAROLINE RD
Second Line	:
City	:	BOZRAH
State	:	CT
Zip	:	06334-1437
Country	:	US
Telephone Number	:	240-731-2935
Fax Number	:

Provider Business Practice Location Address
First Line	:	534 TOWN ST
Second Line	:
City	:	EAST HADDAM
State	:	CT
Zip	:	06423-1390
Country	:	US
Telephone Number	:	240-731-2935
Fax Number	:

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

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	03/18/2014

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