Provider Demographics
NPI:1780263624
Name:HELTERBRAN, ALLIE ALISE (RD, LD)
Entity type:Individual
Prefix:MS
First Name:ALLIE
Middle Name:ALISE
Last Name:HELTERBRAN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22419 HOLLYBRANCH DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2832
Mailing Address - Country:US
Mailing Address - Phone:406-860-0779
Mailing Address - Fax:
Practice Address - Street 1:10210 GROGANS MILL RD STE 320
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1143
Practice Address - Country:US
Practice Address - Phone:406-860-0779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-NUTR-LIC-116161133V00000X
TXDT84939133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered