Provider Demographics
NPI:1467002790
Name:HELM, BRANDY LEE (NDTR)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:LEE
Last Name:HELM
Suffix:
Gender:F
Credentials:NDTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SWIFTWATER RD
Mailing Address - Street 2:
Mailing Address - City:WOODSVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03785-1446
Mailing Address - Country:US
Mailing Address - Phone:603-747-9139
Mailing Address - Fax:
Practice Address - Street 1:90 SWIFTWATER RD
Practice Address - Street 2:
Practice Address - City:WOODSVILLE
Practice Address - State:NH
Practice Address - Zip Code:03785-1446
Practice Address - Country:US
Practice Address - Phone:603-747-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH86049324136A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered