Provider Demographics
NPI:1952558108
Name:BELL, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 COUNTY ROAD DF
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:WI
Mailing Address - Zip Code:53039-9512
Mailing Address - Country:US
Mailing Address - Phone:920-386-3534
Mailing Address - Fax:
Practice Address - Street 1:199 COUNTY ROAD DF
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039-9512
Practice Address - Country:US
Practice Address - Phone:920-386-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI127217-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker