Provider Demographics
NPI:1215166376
Name:WELLS BELLE, ELIZA MAREE (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZA
Middle Name:MAREE
Last Name:WELLS BELLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 TREE CROSSINGS PKWY
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4039
Mailing Address - Country:US
Mailing Address - Phone:205-396-5380
Mailing Address - Fax:
Practice Address - Street 1:1651 RUBY TYLER PKWY
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-2990
Practice Address - Country:US
Practice Address - Phone:205-507-8085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1837103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA12345OtherGRADUATE PSYCHOLOGIST- UNLICENSED