Provider Demographics
NPI:1285304279
Name:HELMEID, REBECCA (MT-BC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HELMEID
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 COMMERCIAL ST APT 201
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:WI
Mailing Address - Zip Code:54614-1802
Mailing Address - Country:US
Mailing Address - Phone:630-945-0776
Mailing Address - Fax:
Practice Address - Street 1:1537 HERITAGE BLVD
Practice Address - Street 2:
Practice Address - City:WEST SALEM
Practice Address - State:WI
Practice Address - Zip Code:54669-9404
Practice Address - Country:US
Practice Address - Phone:608-304-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16669225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist