Provider Demographics
NPI:1255627485
Name:BELL, AMY CAROLINE
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CAROLINE
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4015 VALRICO GROVE DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4828
Mailing Address - Country:US
Mailing Address - Phone:813-777-0549
Mailing Address - Fax:
Practice Address - Street 1:9402 BULLFROG CT
Practice Address - Street 2:
Practice Address - City:GIBSONTON
Practice Address - State:FL
Practice Address - Zip Code:33534-5100
Practice Address - Country:US
Practice Address - Phone:813-335-8296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst