Provider Demographics
NPI:1447767215
Name:BELLO, KAFAYAT
Entity Type:Individual
Prefix:
First Name:KAFAYAT
Middle Name:
Last Name:BELLO
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 1:5 RAINTREE CIR APT F
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-1912
Mailing Address - Country:US
Mailing Address - Phone:347-784-1798
Mailing Address - Fax:
Practice Address - Street 1:5 RAINTREE CIR APT F
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-1912
Practice Address - Country:US
Practice Address - Phone:347-784-1798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor