Individual
STEPHANIE REBECCA BELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, M.ED.
Contact information
Practice address
1375 BONITA AVE, MEDFORD, OR 97504-5505
(157) 128-6685
Mailing address
1375 BONITA AVE, MEDFORD, OR 97504-5505
(571) 286-6859
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
ABA-B-10220939
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-55723
BEHAVIOR ANALYST CERTIFICATION BOARD
—
01
—
ABA-B-10220939
BEHAVIOR ANALYST STATE LICENSE
OR
Enumeration date
03/28/2022
Last updated
03/28/2022
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