Provider Demographics
NPI:1265184915
Name:RIBEIRO, LUCIA (RBT22199331)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:RBT22199331
Other - Prefix:
Other - First Name:LUCIA
Other - Middle Name:PAULA
Other - Last Name:RIBEIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT22199331
Mailing Address - Street 1:437 VALLEY VIEW LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-7315
Mailing Address - Country:US
Mailing Address - Phone:401-339-8282
Mailing Address - Fax:
Practice Address - Street 1:1390 MILLER ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2493
Practice Address - Country:US
Practice Address - Phone:401-339-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT22199331106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty