Provider Demographics
NPI:1356512024
Name:HELSTROM, CAITLIN W (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:W
Last Name:HELSTROM
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:G
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:180 ACADEMY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3183
Mailing Address - Country:US
Mailing Address - Phone:207-760-8100
Mailing Address - Fax:207-760-8188
Practice Address - Street 1:180 ACADEMY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3183
Practice Address - Country:US
Practice Address - Phone:207-760-8100
Practice Address - Fax:207-760-8188
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP1825231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist