Healthcare Provider Details

I. General information

NPI: 1801584495
Provider Name (Legal Business Name): AALEEAH BELL-MCCRARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 VILLAGE SQUARE DR
STONE MOUNTAIN GA
30083-3379
US

IV. Provider business mailing address

715 VILLAGE SQUARE DR
STONE MOUNTAIN GA
30083-3379
US

V. Phone/Fax

Practice location:
  • Phone: 678-761-9847
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: