Provider Demographics
NPI:1720293103
Name:BELL, AMY M (CERT SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:BELL
Suffix:
Gender:F
Credentials:CERT SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 HYDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6568
Mailing Address - Country:US
Mailing Address - Phone:608-397-7200
Mailing Address - Fax:
Practice Address - Street 1:1407 ST ANDREW ST
Practice Address - Street 2:STE 100
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-2378
Practice Address - Country:US
Practice Address - Phone:608-785-5738
Practice Address - Fax:608-785-6315
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9287120171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator