Provider Demographics
NPI:1477801256
Name:BELL, MICHELLE JULIETT (LMFT U/S)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JULIETT
Last Name:BELL
Suffix:
Gender:F
Credentials:LMFT U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14013 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-9787
Mailing Address - Country:US
Mailing Address - Phone:405-551-0923
Mailing Address - Fax:
Practice Address - Street 1:628 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-6256
Practice Address - Country:US
Practice Address - Phone:405-232-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK73-1518027Medicaid