Provider Demographics
NPI:1700911641
Name:BELLADELLA INC
Entity Type:Organization
Organization Name:BELLADELLA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:MSOT OTRL
Authorized Official - Phone:502-387-9079
Mailing Address - Street 1:PO BOX 43952
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40253-0952
Mailing Address - Country:US
Mailing Address - Phone:502-387-9079
Mailing Address - Fax:
Practice Address - Street 1:2201 GOSHEN LN
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:KY
Practice Address - Zip Code:40026-9514
Practice Address - Country:US
Practice Address - Phone:502-468-7626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYR3676225X00000X
KYKYR3673225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty