Provider Demographics
NPI:1598146284
Name:DOUMBIA, BELLA
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:DOUMBIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PECKHAM RD
Mailing Address - Street 2:
Mailing Address - City:ACUSHNET
Mailing Address - State:MA
Mailing Address - Zip Code:02743-1713
Mailing Address - Country:US
Mailing Address - Phone:781-249-0191
Mailing Address - Fax:
Practice Address - Street 1:104 PECKHAM RD
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-1713
Practice Address - Country:US
Practice Address - Phone:781-249-0191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor