Provider Demographics
NPI:1730330820
Name:HELMERT, STACY ELIZABETH (AUD)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:ELIZABETH
Last Name:HELMERT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 HIGHWAY 62 E STE 8
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3276
Mailing Address - Country:US
Mailing Address - Phone:870-424-4838
Mailing Address - Fax:870-424-4878
Practice Address - Street 1:860 HIGHWAY 62 E STE 8
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3276
Practice Address - Country:US
Practice Address - Phone:870-424-4838
Practice Address - Fax:870-424-4878
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist