Provider Demographics
NPI:1992327183
Name:BELL, CAROL (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4560 S CENTRIC WAY
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-9508
Mailing Address - Country:US
Mailing Address - Phone:210-842-3836
Mailing Address - Fax:
Practice Address - Street 1:4560 S CENTRIC WAY
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-9508
Practice Address - Country:US
Practice Address - Phone:210-842-3836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA-343103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst