Healthcare Provider Details

I. General information

NPI: 1851821912
Provider Name (Legal Business Name): NIATRA S BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 HIGHWAY 80 EAST
MONROE LA
71203
US

IV. Provider business mailing address

308 HARN ST.
MONROE LA
71201
US

V. Phone/Fax

Practice location:
  • Phone: 318-343-6966
  • Fax:
Mailing address:
  • Phone: 318-503-3760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: