Provider Demographics
NPI:1215401492
Name:BELL, MICHAELA ELIZABETH (OTR)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ELIZABETH
Last Name:BELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 BROOKS LN
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76705-1506
Mailing Address - Country:US
Mailing Address - Phone:615-663-5001
Mailing Address - Fax:
Practice Address - Street 1:2320 LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-1276
Practice Address - Country:US
Practice Address - Phone:254-752-1075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114812225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist