Provider Demographics
NPI:1053568352
Name:BELL, SHIELA RAE (COTA)
Entity type:Individual
Prefix:MRS
First Name:SHIELA
Middle Name:RAE
Last Name:BELL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SHIELA
Other - Middle Name:RAE
Other - Last Name:OBERLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2888 N.LONG GROVE RD.
Mailing Address - Street 2:
Mailing Address - City:CECILIA
Mailing Address - State:KY
Mailing Address - Zip Code:42724
Mailing Address - Country:US
Mailing Address - Phone:270-862-3400
Mailing Address - Fax:
Practice Address - Street 1:106 DIECKS DRIVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701
Practice Address - Country:US
Practice Address - Phone:270-769-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-A1486224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant