Provider Demographics
NPI:1558694158
Name:BELL, ANGELA N (MAOM, LICAC,)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:N
Last Name:BELL
Suffix:
Gender:F
Credentials:MAOM, LICAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LAKEWOOD ESTS
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:ME
Mailing Address - Zip Code:04963-3519
Mailing Address - Country:US
Mailing Address - Phone:617-512-3193
Mailing Address - Fax:
Practice Address - Street 1:619 BRIGHTON AVE STE 101
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2373
Practice Address - Country:US
Practice Address - Phone:207-807-4139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238382171100000X
MEAC387171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist