Helen D Ezelll, LPN, BA
Individual provider Active NPI Developmental Therapist · Lynn Haven, FL
NPI 1508155706 · NPPES record last updated Mar 29, 2011
Key facts
- NPI
- 1508155706
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- License
- 001768700 (FL)
- Practice address
- 1612 Tennessee Ave
Lynn Haven, FL 32444-3653 - Phone
- (850) 248-0030
- NPI assigned
- Mar 29, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001768700 | FL | MD | Developmental Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 001768700 | FL | Yes |
Addresses
Primary practice location
1612 Tennessee Ave
Lynn Haven, FL 32444-3653
Mailing address
1612 Tennessee Ave
Lynn Haven, FL 32444-3653
Phone (850) 248-0030
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001768700 | Medicaid | FL |
Other providers in Lynn Haven, FL
- Emerald Coast Walk in Clinic LLC
- Emerald Shores Chiropractic LLC
- Frederick B Epstein
- Jinan Erchid
- Excellence Physical Therapy LLC
- F. Reese Harrison, DMD, PA
- Carlos Humberto Fernandez
- Ashley Ann Ferrell
- Erika J Finch
- Ann Marie Fowler-Pyle
All providers in Lynn Haven, FL · Developmental Therapist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.