=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598019259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERTA BELL PH.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2012
-----------------------------------------------------
Last Update Date | 11/02/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4937 HEARST ST STE. 2-J
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-1120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-885-8494
-----------------------------------------------------
Fax | 504-885-8497
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4937 HEARST ST STE. 2-J
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-1120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-885-8494
-----------------------------------------------------
Fax | 504-885-8497
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103G00000X
-----------------------------------------------------
Taxonomy Name | Clinical Neuropsychologist
-----------------------------------------------------
License Number | 536
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------