Provider Demographics
NPI:1952155962
Name:BELTON, BELLA GRACE (TBS)
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:GRACE
Last Name:BELTON
Suffix:
Gender:F
Credentials:TBS
Other - Prefix:
Other - First Name:SERINA
Other - Middle Name:CELINE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3757 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9373
Mailing Address - Country:US
Mailing Address - Phone:740-815-6049
Mailing Address - Fax:
Practice Address - Street 1:2436 W DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-2709
Practice Address - Country:US
Practice Address - Phone:740-815-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator