Provider Demographics
NPI:1992156715
Name:BELLARD, CARLEEN
Entity type:Individual
Prefix:
First Name:CARLEEN
Middle Name:
Last Name:BELLARD
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 1:519 E BEAUREGARD ST
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-3501
Mailing Address - Country:US
Mailing Address - Phone:337-363-3703
Mailing Address - Fax:337-363-4008
Practice Address - Street 1:519 E BEAUREGARD ST
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586
Practice Address - Country:US
Practice Address - Phone:337-363-3703
Practice Address - Fax:337-363-4008
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator