Provider Demographics
NPI:1821218181
Name:BELL, KATHERINE C (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:C
Last Name:BELL
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63957-1222
Mailing Address - Country:US
Mailing Address - Phone:573-223-4812
Mailing Address - Fax:573-223-7820
Practice Address - Street 1:CLEARWATER R-1 SCHOOL DISTRICT
Practice Address - Street 2:825 N MAIN ST
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1222
Practice Address - Country:US
Practice Address - Phone:573-223-4812
Practice Address - Fax:573-223-7820
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118031235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO464767334Medicaid