Provider Demographics
NPI:1154779080
Name:BELL, ACKSANNA (MA)
Entity type:Individual
Prefix:
First Name:ACKSANNA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-2922
Mailing Address - Country:US
Mailing Address - Phone:407-291-8009
Mailing Address - Fax:
Practice Address - Street 1:3544 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-2922
Practice Address - Country:US
Practice Address - Phone:407-291-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2711OtherMARRIAGE AND FAMILY THERAPIST INTERN