Provider Demographics
NPI:1811266828
Name:BESAL, HELEN M (LMT)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:M
Last Name:BESAL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98072
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30359-1772
Mailing Address - Country:US
Mailing Address - Phone:770-355-2407
Mailing Address - Fax:
Practice Address - Street 1:3300 N E EXPY NE
Practice Address - Street 2:BLDG 8 SUITE C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-3932
Practice Address - Country:US
Practice Address - Phone:770-500-3848
Practice Address - Fax:678-868-1114
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
GAMT000815225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist