MEDICARE: ANGELIQUE BELLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT110229	TX

General Provider Information

NPI Number	:	1598364002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIQUE BELLA

Provider Business Mailing Address
First Line	:	2832 RUSH CREEK RD
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-7224
Country	:	US
Telephone Number	:	469-268-4035
Fax Number	:

Provider Business Practice Location Address
First Line	:	2832 RUSH CREEK RD
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75072-7224
Country	:	US
Telephone Number	:	469-268-4035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	10/26/2020

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Directions to “ ANGELIQUE BELLA ” Practice Location

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