Provider Demographics
NPI:1861555658
Name:HELMS TILLERY, AUGUSTA K (SLP)
Entity type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:K
Last Name:HELMS TILLERY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ARIZONA ST UNIV DEPT SPEECH & HEARING SCI
Mailing Address - Street 2:975 S. MYRTLE AVE., COOR HALL 2211
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85287-0102
Mailing Address - Country:US
Mailing Address - Phone:480-965-2373
Mailing Address - Fax:
Practice Address - Street 1:ARIZONA ST UNIV DEPT SPEECH & HEARING SCI
Practice Address - Street 2:975 S. MYRTLE AVE., COOR HALL 2211
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85287-0102
Practice Address - Country:US
Practice Address - Phone:480-965-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0869235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist