# LISA M TAUTIVA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1598897423
- **Gender:** F
- **Credential:** R.D.M.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246Z00000X | Other Specialist/Technologist | 37159 | MA | Yes |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 07/09/2007

## 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 |