Provider Demographics
NPI:1205300084
Name:MEZZOMO, HELEN ANGELA
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:ANGELA
Last Name:MEZZOMO
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 1:103 MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-4351
Mailing Address - Country:US
Mailing Address - Phone:347-393-0663
Mailing Address - Fax:
Practice Address - Street 1:5451 BEAVERKILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2359
Practice Address - Country:US
Practice Address - Phone:347-393-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist