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General NPI Number Information
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NPI Number | 1417860727
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Entity Type | Individual
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Provider Name | BEATRIZ PONTES DE LUCENA DOMINGUES
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Gender | Female
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Dates
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Enumeration Date | 09/26/2026
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Last Update Date | 09/26/2026
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Provider Practice Location Address
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Address Line | 1 HOPE ST
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City | BRISTOL
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State | CT
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Zip | 06010-6374
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Country | US
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Telephone | 888-793-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CLARK AVE APT 19
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City | BRISTOL
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State | CT
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Zip | 06010-4080
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Country | US
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Telephone | 860-877-7938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 10187
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License Number State | CT
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