Healthcare Provider Details

I. General information

NPI: 1659777936
Provider Name (Legal Business Name): KATHERINE BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 1ST ST E STE A
INDEPENDENCE IA
50644-2815
US

IV. Provider business mailing address

324 1ST ST E STE A
INDEPENDENCE IA
50644-2815
US

V. Phone/Fax

Practice location:
  • Phone: 319-332-2512
  • Fax:
Mailing address:
  • Phone: 319-332-2512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number400
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: