Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 4083 | NM |
NPI | 1003298704 |
---|---|
Provider Name | Lyra Helms |
First Address | Albuquerque, NM 87113-1345 |
Second Address | Albuquerque, NM 87107-2620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 09/03/2019 |