Provider Demographics
NPI:1154906253
Name:BELL, BRIANNA TYKIA
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:TYKIA
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8539 GATE PKWY W UNIT 1412
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1045
Mailing Address - Country:US
Mailing Address - Phone:863-419-6730
Mailing Address - Fax:
Practice Address - Street 1:8539 GATE PKWY W UNIT 1412
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1045
Practice Address - Country:US
Practice Address - Phone:863-419-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist