Provider Demographics
NPI:1942589585
Name:LUTTS, LAETITIA FRANCES (MT-BC)
Entity Type:Individual
Prefix:
First Name:LAETITIA
Middle Name:FRANCES
Last Name:LUTTS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MARION ST
Mailing Address - Street 2:APT.1
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:81 MARION ST
Practice Address - Street 2:APT.1
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3951
Practice Address - Country:US
Practice Address - Phone:857-544-6026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-14
Last Update Date:2011-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
09335OtherCERTIFICATION BOARD FOR MUSIC THERAPISTS