Provider Demographics
NPI:1558967364
Name:BELL, ALICIA GRACE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:GRACE
Last Name:BELL
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4630 N PASEO AQUIMURI
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1612
Mailing Address - Country:US
Mailing Address - Phone:520-343-3495
Mailing Address - Fax:
Practice Address - Street 1:1132 W DICKENS AVE # 1R
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4135
Practice Address - Country:US
Practice Address - Phone:520-343-3495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered