Healthcare Provider Details

I. General information

NPI: 1265041677
Provider Name (Legal Business Name): KAYLEE NICOLE BELL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLEE NICOLE MCNIEL MA

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 SCHOOL HOUSE RIDGE RD
DRYDEN VA
24243-8359
US

IV. Provider business mailing address

605 HICKORY LN
HARLAN KY
40831-2000
US

V. Phone/Fax

Practice location:
  • Phone: 276-546-4443
  • Fax:
Mailing address:
  • Phone: 606-273-6372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2204000570
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: