MEDICARE: MS. JANET SARA BELLMAN

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	1041C0700X	Clinical Social Worker	02780	TX

General Provider Information

NPI Number	:	1962501452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANET SARA BELLMAN

Provider Business Mailing Address
First Line	:	3012 EAGLE MOUNTAIN DR
Second Line	:
City	:	WYLIE
State	:	TX
Zip	:	75098-7390
Country	:	US
Telephone Number	:	214-474-2477
Fax Number	:	214-474-2477

Provider Business Practice Location Address
First Line	:	8059 SCYENE CIR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75227-5534
Country	:	US
Telephone Number	:	800-257-8715
Fax Number	:	800-819-1655

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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