Provider Demographics
NPI:1760490551
Name:BELL-NAGLE, THERESA (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:BELL-NAGLE
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 LONGWATER CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1643
Mailing Address - Country:US
Mailing Address - Phone:781-421-3771
Mailing Address - Fax:781-421-3943
Practice Address - Street 1:99 LONGWATER CIR STE 102
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1643
Practice Address - Country:US
Practice Address - Phone:781-421-3771
Practice Address - Fax:781-421-3943
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3102225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAOT0019OtherBLUE SHIELD
MAY68685Medicare ID - Type Unspecified
MAY6868501Medicare PIN