Provider Demographics
NPI:1003298704
Name:HELMS, LYRA
Entity Type:Individual
Prefix:
First Name:LYRA
Middle Name:
Last Name:HELMS
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 1:7235 VIA CONTENTA NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1345
Mailing Address - Country:US
Mailing Address - Phone:423-930-4842
Mailing Address - Fax:
Practice Address - Street 1:11 GARDEN PARK CIR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-2620
Practice Address - Country:US
Practice Address - Phone:423-930-4842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
373H00000X
NM4083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist