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Individual

LUZ MARIA MATUL-IXLAJ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
176 FRANKLIN ST, LYNN, MA 01904-3230
(781) 593-2727
Mailing address
43 GOLDTHWAIT ST, LYNN, MA 01902-2613

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1922174226
DEVELOPMENTAL SERVICES
Enumeration date
07/19/2023
Last updated
07/19/2023
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