Provider Demographics
NPI:1003390774
Name:ARAUJO, LOURDES (MS)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:
Last Name:ARAUJO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:LOURDES
Other - Middle Name:
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 990492
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6066
Mailing Address - Country:US
Mailing Address - Phone:239-641-9007
Mailing Address - Fax:
Practice Address - Street 1:1570 SHADOWLAWN DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4321
Practice Address - Country:US
Practice Address - Phone:239-641-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16284101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty