Healthcare Provider Details

I. General information

NPI: 1417174681
Provider Name (Legal Business Name): KIMBERLY M BELL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19910 MALVERN RD
SHAKER HEIGHTS OH
44122-2823
US

IV. Provider business mailing address

3327 DELLWOOD RD
CLEVELAND HEIGHTS OH
44118-3404
US

V. Phone/Fax

Practice location:
  • Phone: 216-929-0223
  • Fax:
Mailing address:
  • Phone: 216-407-8870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6206
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: