Provider Demographics
NPI:1285871640
Name:BLACK HELBLING, WENDY ROSE
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ROSE
Last Name:BLACK HELBLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ROSE
Other - Last Name:BLACK HELBLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1813 W HARVARD
Mailing Address - Street 2:STE 436 ROSEBURG
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471
Mailing Address - Country:US
Mailing Address - Phone:541-464-6464
Mailing Address - Fax:541-677-6487
Practice Address - Street 1:1813 W HARVARD
Practice Address - Street 2:STE 436
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471
Practice Address - Country:US
Practice Address - Phone:541-464-6464
Practice Address - Fax:541-677-3487
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay