Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT0000000442 | TN |
NPI | 1013932060 |
---|---|
Provider Name | Mrs. Janel Danos Bell |
First Address | Knoxville, TN 37922-2108 |
Second Address | Kingston, TN 37763-4721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4115784 | BLUECROSS BLUESHIELD (01) | TN |
5440744 | (05) | TN |