Healthcare Provider Details

I. General information

NPI: 1992955256
Provider Name (Legal Business Name): ANNA BELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4109 HIGHWAY 98 W
SUMMIT MS
39666-9132
US

IV. Provider business mailing address

4109 HIGHWAY 98 W
SUMMIT MS
39666-9132
US

V. Phone/Fax

Practice location:
  • Phone: 601-276-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS2452
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number103959
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: