Provider Demographics
NPI:1316148943
Name:BELL, GRACE CAROL (PHD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:CAROL
Last Name:BELL
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 1:4251 APPOMATTOX DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-4107
Mailing Address - Country:US
Mailing Address - Phone:419-882-3115
Mailing Address - Fax:
Practice Address - Street 1:4251 APPOMATTOX DR
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-4107
Practice Address - Country:US
Practice Address - Phone:419-882-3115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical