Provider Demographics
NPI:1194064238
Name:BUTLER, HELGA
Entity type:Individual
Prefix:
First Name:HELGA
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 W MAGEE RD APT 9102
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4667
Mailing Address - Country:US
Mailing Address - Phone:520-834-2968
Mailing Address - Fax:
Practice Address - Street 1:1200 N EL DORADO PL STE A150
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4637
Practice Address - Country:US
Practice Address - Phone:520-298-7883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-09
Last Update Date:2013-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5158224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5158OtherSTATE LICENCE