Provider Demographics
NPI:1710761218
Name:BELLO, MARIEM (LMT)
Entity Type:Individual
Prefix:
First Name:MARIEM
Middle Name:
Last Name:BELLO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12820 GREENWOOD FOREST DR APT 1629
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-1646
Mailing Address - Country:US
Mailing Address - Phone:813-770-2530
Mailing Address - Fax:
Practice Address - Street 1:12820 GREENWOOD FOREST DR APT 1629
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-1646
Practice Address - Country:US
Practice Address - Phone:813-770-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT135652225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty