Doctor Name: | ALYCIA A BELLAH |
NPI Number: | 1568421493 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2490 |
Business Practice Address: | 1801 Fairfield Ave Suite 409 Shreveport, LA - 711014443 |
Business Phone Number: | 3188482801 |
Business Fax Number: | 3188482802 |
Mailing Address: | 1801 Fairfield Ave, Suite 409 SHREVEPORT |
State: | LA |
Postal Code: | 711014443 |
Phone Number: | 3188482801 |
Fax Number: | 3188482802 |
NPI Enumeration Date: | 03/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2490 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |