MEDICARE: RANDI BELL SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP5153	AZ

General Provider Information

NPI Number	:	1174671895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI BELL SLP

Provider Business Mailing Address
First Line	:	PO BOX 711185
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84171-1185
Country	:	US
Telephone Number	:	801-942-3311
Fax Number	:	801-942-5955

Provider Business Practice Location Address
First Line	:	1952 FORT UNION BLVD
Second Line	:	SUITE 100
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-6877
Country	:	US
Telephone Number	:	801-942-3311
Fax Number	:	801-942-5955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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Directions to “ RANDI BELL SLP” Practice Location

Language	Start Address	Practice Location

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