Provider Demographics
NPI:1023214376
Name:BELL, LETA (MS, MA)
Entity Type:Individual
Prefix:MS
First Name:LETA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:MS
Other - First Name:LETA
Other - Middle Name:JO
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1748 S YORKTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5339
Mailing Address - Country:US
Mailing Address - Phone:918-585-3170
Mailing Address - Fax:918-744-4432
Practice Address - Street 1:4300 S HARVARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2619
Practice Address - Country:US
Practice Address - Phone:918-585-3170
Practice Address - Fax:918-744-4432
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health