Provider Demographics
NPI:1487701900
Name:DALLAIRE, HELEN M (LMT)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:M
Last Name:DALLAIRE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:HELEN
Other - Middle Name:M
Other - Last Name:CIAMPI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 587
Mailing Address - Street 2:
Mailing Address - City:FLORAL CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34436-0587
Mailing Address - Country:US
Mailing Address - Phone:352-341-2867
Mailing Address - Fax:
Practice Address - Street 1:9255 S STARFISH AVE
Practice Address - Street 2:
Practice Address - City:FLORAL CITY
Practice Address - State:FL
Practice Address - Zip Code:34436-5603
Practice Address - Country:US
Practice Address - Phone:352-341-2867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA33308174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist