Provider Demographics
NPI:1982448403
Name:BELL, TIFFANY ALEXIS
Entity type:Individual
Prefix:PROF
First Name:TIFFANY
Middle Name:ALEXIS
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 BELTSVILLE DR # 500A15
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3166
Mailing Address - Country:US
Mailing Address - Phone:202-790-8903
Mailing Address - Fax:301-889-9735
Practice Address - Street 1:11720 BELTSVILLE DR # 500A15
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3166
Practice Address - Country:US
Practice Address - Phone:202-790-8903
Practice Address - Fax:301-889-9735
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service