Provider Demographics
NPI:1013676907
Name:BELT, MARILYN KAY (CCHW)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:KAY
Last Name:BELT
Suffix:
Gender:F
Credentials:CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:KY
Mailing Address - Zip Code:42078-0316
Mailing Address - Country:US
Mailing Address - Phone:270-988-3226
Mailing Address - Fax:270-988-4357
Practice Address - Street 1:119 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:KY
Practice Address - Zip Code:42078-9998
Practice Address - Country:US
Practice Address - Phone:270-988-3226
Practice Address - Fax:270-988-4357
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date: