Individual
MS. JENNIFER L LUCIN-MAIETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1316
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1316
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962642215
FCHP
—
01
—
6916604
AETNA
—
01
—
908317
TUFTS
—
01
—
B501027
HEALTHSOURCE
—
01
—
GROUP #
PHCS
—
01
—
HV0002
HPHC
—
01
—
SP0334
BCBS INDEMNITY
—
Enumeration date
02/26/2009
Last updated
12/20/2011
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