Provider Demographics
NPI:1376235481
Name:BELL, DYLAN MIKAYLA
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:MIKAYLA
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 1:203 W 81ST ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5817
Mailing Address - Country:US
Mailing Address - Phone:917-969-7308
Mailing Address - Fax:
Practice Address - Street 1:9715 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3004
Practice Address - Country:US
Practice Address - Phone:314-648-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker