Provider Demographics
NPI:1164904215
Name:HELT, DYANA
Entity Type:Individual
Prefix:
First Name:DYANA
Middle Name:
Last Name:HELT
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 1:528 VIOLET AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-1087
Mailing Address - Country:US
Mailing Address - Phone:414-349-7564
Mailing Address - Fax:414-479-9923
Practice Address - Street 1:528 VIOLET AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1087
Practice Address - Country:US
Practice Address - Phone:414-349-7564
Practice Address - Fax:414-479-9923
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2571225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist