Provider Demographics
NPI:1912069162
Name:HELENIUS, LISA CHRISTY (MOT, OTRL)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CHRISTY
Last Name:HELENIUS
Suffix:
Gender:F
Credentials:MOT, OTRL
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 804
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-0804
Mailing Address - Country:US
Mailing Address - Phone:505-737-9328
Mailing Address - Fax:
Practice Address - Street 1:200 SANDERS LN
Practice Address - Street 2:
Practice Address - City:RANCHOS DE TAOS
Practice Address - State:NM
Practice Address - Zip Code:87557-7809
Practice Address - Country:US
Practice Address - Phone:505-737-9328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1565225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist