Provider Demographics
NPI:1689711640
Name:WU, HELENA M (LM, CPM)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:M
Last Name:WU
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH LONDONDERRY
Mailing Address - State:VT
Mailing Address - Zip Code:05155-9144
Mailing Address - Country:US
Mailing Address - Phone:802-856-7140
Mailing Address - Fax:
Practice Address - Street 1:1290 MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:SOUTH LONDONDERRY
Practice Address - State:VT
Practice Address - Zip Code:05155-9144
Practice Address - Country:US
Practice Address - Phone:802-856-7140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT107-0000017176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009880Medicaid