Provider Demographics
NPI:1770975211
Name:HELMS, LARISSA (RD, LDN)
Entity type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:HELMS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MARSTON ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2310
Mailing Address - Country:US
Mailing Address - Phone:978-683-4000
Mailing Address - Fax:978-946-8213
Practice Address - Street 1:25 MARSTON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2310
Practice Address - Country:US
Practice Address - Phone:978-683-4000
Practice Address - Fax:978-946-8213
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3235133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered