Provider Demographics
NPI:1629803283
Name:BELL, IVIAN N'YATTI CARLISIA (RSW)
Entity type:Individual
Prefix:MS
First Name:IVIAN
Middle Name:N'YATTI CARLISIA
Last Name:BELL
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 Y A TITTLE AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-3662
Mailing Address - Country:US
Mailing Address - Phone:337-241-0795
Mailing Address - Fax:
Practice Address - Street 1:4606 Y A TITTLE AVE APT 21
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-3662
Practice Address - Country:US
Practice Address - Phone:337-241-0795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18550171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator