Provider Demographics
NPI:1205170636
Name:REILLY BELL, PATRICIA ELIZABETH (CERTIFIED SCHOOL PSY)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELIZABETH
Last Name:REILLY BELL
Suffix:
Gender:F
Credentials:CERTIFIED SCHOOL PSY
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:E
Other - Last Name:REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1413 STEEL RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4815
Mailing Address - Country:US
Mailing Address - Phone:610-574-7262
Mailing Address - Fax:610-544-7142
Practice Address - Street 1:1254 W CHESTER PIKE
Practice Address - Street 2:SUITE 206-A
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3338
Practice Address - Country:US
Practice Address - Phone:484-450-6476
Practice Address - Fax:610-544-7142
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA103K00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool