Provider Demographics
NPI:1720308554
Name:BELLO, NATHALIE DUQUE (PH D, LMFT)
Entity Type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:DUQUE
Last Name:BELLO
Suffix:
Gender:F
Credentials:PH D, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 SHERIDAN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1505
Mailing Address - Country:US
Mailing Address - Phone:954-778-1538
Mailing Address - Fax:
Practice Address - Street 1:11011 SHERIDAN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-1505
Practice Address - Country:US
Practice Address - Phone:954-778-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2319106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist