Provider Demographics
NPI:1669741757
Name:DEMETRION, HELEN KATHLEEN (MS)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:KATHLEEN
Last Name:DEMETRION
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3694 W MEYERS RD
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-1720
Mailing Address - Country:US
Mailing Address - Phone:909-887-1826
Mailing Address - Fax:
Practice Address - Street 1:3694 W MEYERS RD
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-1720
Practice Address - Country:US
Practice Address - Phone:909-887-1826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist