Provider Demographics
NPI:1124423819
Name:BELL, REBECCA (MED)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 PIERCE RD
Mailing Address - Street 2:
Mailing Address - City:BOKOSHE
Mailing Address - State:OK
Mailing Address - Zip Code:74930-2548
Mailing Address - Country:US
Mailing Address - Phone:918-658-8304
Mailing Address - Fax:
Practice Address - Street 1:700 PIERCE RD
Practice Address - Street 2:
Practice Address - City:BOKOSHE
Practice Address - State:OK
Practice Address - Zip Code:74930-2548
Practice Address - Country:US
Practice Address - Phone:918-658-8304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2013235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist