Provider Demographics
NPI:1972656882
Name:BELL, BREANNA LEE (MA, SRLPE)
Entity Type:Individual
Prefix:MS
First Name:BREANNA
Middle Name:LEE
Last Name:BELL
Suffix:
Gender:F
Credentials:MA, SRLPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3851
Mailing Address - Country:US
Mailing Address - Phone:615-904-0358
Mailing Address - Fax:
Practice Address - Street 1:151 HERITAGE PARK DR
Practice Address - Street 2:STE 303
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0505
Practice Address - Country:US
Practice Address - Phone:615-893-9949
Practice Address - Fax:615-893-9927
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000011176103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling