Healthcare Provider Details

I. General information

NPI: 1295820181
Provider Name (Legal Business Name): DEBORA JENEEN BELL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSYCHOLOGICAL SERVICES CLINIC UNIVERSITY OF MISSOURI 211 S. 8TH STREET
COLUMBIA MO
65211-0001
US

IV. Provider business mailing address

PSYCHOLOGICAL SERVICES CLINIC UNIVERSITY OF MISSOURI 211 S. 8TH STREET
COLUMBIA MO
65211-0001
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-2254
  • Fax:
Mailing address:
  • Phone: 573-882-2254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number01491
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: