Healthcare Provider Details

I. General information

NPI: 1912799248
Provider Name (Legal Business Name): TARYN RAE BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#1 5TH ST
HYDABURG AK
99922
US

IV. Provider business mailing address

721 STEDMAN ST
KETCHIKAN AK
99901-6632
US

V. Phone/Fax

Practice location:
  • Phone: 907-225-7825
  • Fax:
Mailing address:
  • Phone: 907-225-7825
  • Fax: 907-225-1541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: