Provider Demographics
NPI:1811376528
Name:BELL, JENNY (SLP)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9055
Mailing Address - Country:US
Mailing Address - Phone:870-740-1163
Mailing Address - Fax:
Practice Address - Street 1:1606 PINE GROVE LN
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:AR
Practice Address - Zip Code:72432-9304
Practice Address - Country:US
Practice Address - Phone:870-578-5426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#3996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist