Provider Demographics
NPI:1376947606
Name:BELL, BRYAN D (MINT)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:D
Last Name:BELL
Suffix:
Gender:M
Credentials:MINT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 N REDMOND AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2842
Mailing Address - Country:US
Mailing Address - Phone:495-249-3471
Mailing Address - Fax:
Practice Address - Street 1:4216 N REDMOND AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2842
Practice Address - Country:US
Practice Address - Phone:495-249-3471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor