Healthcare Provider Details

I. General information

NPI: 1386878114
Provider Name (Legal Business Name): SHERYL L BELL E.D.M. PA/A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2009
Last Update Date: 05/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 2ND ST NE
CANTON OH
44704-1132
US

IV. Provider business mailing address

919 2ND ST NE
CANTON OH
44704-1132
US

V. Phone/Fax

Practice location:
  • Phone: 330-454-7917
  • Fax: 330-454-1476
Mailing address:
  • Phone: 330-454-7917
  • Fax: 330-454-1476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: