Provider Demographics
NPI:1467258699
Name:BELLO-CORDOVA, ALHENA ARIDED
Entity type:Individual
Prefix:
First Name:ALHENA
Middle Name:ARIDED
Last Name:BELLO-CORDOVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 FAIRVIEW TER
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-3323
Mailing Address - Country:US
Mailing Address - Phone:317-993-7122
Mailing Address - Fax:
Practice Address - Street 1:1143 E 181ST ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-8926
Practice Address - Country:US
Practice Address - Phone:317-432-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician