Provider Demographics
NPI:1386998474
Name:SPANN, HELEN L (COTA)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:L
Last Name:SPANN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GOLDIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2102
Mailing Address - Country:US
Mailing Address - Phone:845-238-8906
Mailing Address - Fax:
Practice Address - Street 1:65 GOLDIN BLVD
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-2102
Practice Address - Country:US
Practice Address - Phone:845-238-8906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008191-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant