Provider Demographics
NPI:1083152110
Name:BELL, CHARLIE A
Entity Type:Individual
Prefix:
First Name:CHARLIE
Middle Name:A
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 1:1222 10TH ST STE 211
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3156
Mailing Address - Country:US
Mailing Address - Phone:580-571-3225
Mailing Address - Fax:580-256-8609
Practice Address - Street 1:1521 HIGHWAY 54 N.
Practice Address - Street 2:P.O. 1247
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942
Practice Address - Country:US
Practice Address - Phone:580-338-5851
Practice Address - Fax:580-338-6022
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor