Provider Demographics
NPI:1235658477
Name:BELL, BRIGITTA (BCBA)
Entity Type:Individual
Prefix:
First Name:BRIGITTA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-0172
Mailing Address - Country:US
Mailing Address - Phone:916-661-8524
Mailing Address - Fax:
Practice Address - Street 1:4994 N US-101
Practice Address - Street 2:
Practice Address - City:NEOTSU
Practice Address - State:OR
Practice Address - Zip Code:97364-9736
Practice Address - Country:US
Practice Address - Phone:503-383-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
ORABA-B-10201046103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician