Provider Demographics
NPI:1962156794
Name:BELL, LINDA LOU (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LOU
Last Name:BELL
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N MAIN ST APT 208
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-4850
Mailing Address - Country:US
Mailing Address - Phone:573-380-2070
Mailing Address - Fax:
Practice Address - Street 1:955 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:NEW MADRID
Practice Address - State:MO
Practice Address - Zip Code:63869-9206
Practice Address - Country:US
Practice Address - Phone:573-748-5568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022002513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist