Provider Demographics
NPI:1669638003
Name:BELL, ALICIA BRAINARD (ST)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:BRAINARD
Last Name:BELL
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 OLD MONTICELLO ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2357
Mailing Address - Country:US
Mailing Address - Phone:606-677-1166
Mailing Address - Fax:606-451-3386
Practice Address - Street 1:127 OLD MONTICELLO ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2357
Practice Address - Country:US
Practice Address - Phone:606-677-1166
Practice Address - Fax:606-451-3386
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-08-033235Z00000X
KY3595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist