Provider Demographics
NPI:1225375637
Name:PONTES, AIMEE (TM)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:
Last Name:PONTES
Suffix:
Gender:F
Credentials:TM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MISSILE LOOP
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-5003
Mailing Address - Country:US
Mailing Address - Phone:508-642-5121
Mailing Address - Fax:
Practice Address - Street 1:350 MYLES STANDISH BLVD
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-7387
Practice Address - Country:US
Practice Address - Phone:508-642-5121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator