Provider Demographics
NPI:1467767376
Name:BELL, LOURDES CHAMBERS (BS, MS)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:CHAMBERS
Last Name:BELL
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:MISS
Other - First Name:LOURDES
Other - Middle Name:
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, MS
Mailing Address - Street 1:2765 N WALNUT HILLS DR
Mailing Address - Street 2:UNIT #55
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-7101
Mailing Address - Country:US
Mailing Address - Phone:520-820-9180
Mailing Address - Fax:
Practice Address - Street 1:2765 N WALNUT HILLS DR
Practice Address - Street 2:UNIT #55
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-7101
Practice Address - Country:US
Practice Address - Phone:520-820-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP6669235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist