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Individual
LISA M TAUTIVA
Active
Individual
LISA M TAUTIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.M.S.
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
37159
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039469
BLUE CROSS BLUE SHIELD
MA
01
—
3755396
AETNA
MA
01
—
80314
UNICARE
MA
01
—
AA24533
HARVARD PILGRIM
MA
Enumeration date
03/09/2007
Last updated
07/09/2007
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