Provider Demographics
NPI:1578052544
Name:BELL, LAURA (RBT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 LAKE HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-9247
Mailing Address - Country:US
Mailing Address - Phone:630-335-6405
Mailing Address - Fax:
Practice Address - Street 1:823 LAKE HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-9247
Practice Address - Country:US
Practice Address - Phone:630-335-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-06
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst