Healthcare Provider Details

I. General information

NPI: 1164330999
Provider Name (Legal Business Name): MAYA SLUTSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 RIVER RD
ANDOVER MA
01810-4349
US

IV. Provider business mailing address

307 PAWTUCKET BLVD UNIT 1
LOWELL MA
01854-2951
US

V. Phone/Fax

Practice location:
  • Phone: 978-654-4300
  • Fax: 978-654-4381
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: