Provider Demographics
NPI:1952391898
Name:WILLARD, HELEN NELSON (MED, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:NELSON
Last Name:WILLARD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:MRS
Other - First Name:HELEN
Other - Middle Name:NELSON
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BED, CCC-SLP
Mailing Address - Street 1:1509 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5531
Mailing Address - Country:US
Mailing Address - Phone:919-469-0913
Mailing Address - Fax:919-469-0913
Practice Address - Street 1:1509 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5531
Practice Address - Country:US
Practice Address - Phone:919-469-0913
Practice Address - Fax:919-469-0913
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC680235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13654OtherID FOR BCBS OF NC
NC0661842OtherSEC. OF ST. L.L.C. ID #