Provider Demographics
NPI:1598019259
Name:BELL, ROBERTA (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4937 HEARST ST
Mailing Address - Street 2:STE. 2-J
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1120
Mailing Address - Country:US
Mailing Address - Phone:504-885-8494
Mailing Address - Fax:504-885-8497
Practice Address - Street 1:4937 HEARST ST
Practice Address - Street 2:STE. 2-J
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1120
Practice Address - Country:US
Practice Address - Phone:504-885-8494
Practice Address - Fax:504-885-8497
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA536103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist