Provider Demographics
NPI:1114474988
Name:BELL, LISA MECHELLE
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MECHELLE
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 1:1400 PENN LN
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2638
Mailing Address - Country:US
Mailing Address - Phone:405-314-3599
Mailing Address - Fax:
Practice Address - Street 1:1400 PENN LN
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2638
Practice Address - Country:US
Practice Address - Phone:405-314-3599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst