Provider Demographics
NPI:1649401365
Name:HELBIG, LEAH JO (COTA)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:JO
Last Name:HELBIG
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 1:234 N LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:DU QUOIN
Mailing Address - State:IL
Mailing Address - Zip Code:62832-1020
Mailing Address - Country:US
Mailing Address - Phone:618-357-2187
Mailing Address - Fax:618-357-6336
Practice Address - Street 1:101 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:PINCKNEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62274-1034
Practice Address - Country:US
Practice Address - Phone:618-357-2187
Practice Address - Fax:618-357-6336
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057002891224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant