Provider Demographics
NPI:1427433812
Name:BELLO, CHRISTAL MARIE (MA, BCBA)
Entity type:Individual
Prefix:MISS
First Name:CHRISTAL
Middle Name:MARIE
Last Name:BELLO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 OXFORD ST S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-1815
Mailing Address - Country:US
Mailing Address - Phone:774-261-3489
Mailing Address - Fax:
Practice Address - Street 1:727 OXFORD ST S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-1815
Practice Address - Country:US
Practice Address - Phone:774-261-3489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-15-18679103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst