Individual
DOUGLAS BELLAMY
Active
Individual
DOUGLAS BELLAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
21998
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038966001
—
TX
01
—
21998
STATE LICENSE
TX
01
—
4108749
AETNA ID
TX
01
—
81618P
BLUE CROSS ID
TX
01
—
OP21998
WC ID
TX
Enumeration date
03/08/2007
Last updated
04/05/2013
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