Provider Demographics
NPI:1972894186
Name:QUALLS, HELEN MONDEZ
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:MONDEZ
Last Name:QUALLS
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 1:9 MOEN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2414
Mailing Address - Country:US
Mailing Address - Phone:774-265-2025
Mailing Address - Fax:
Practice Address - Street 1:9 MOEN ST APT 2
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2414
Practice Address - Country:US
Practice Address - Phone:774-265-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health