Healthcare Provider Details

I. General information

NPI: 1629809751
Provider Name (Legal Business Name): LISA SAINT CYR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 OLD COLONY AVE APT 477
SOUTH BOSTON MA
02127-3809
US

IV. Provider business mailing address

403 OLD COLONY AVE
SOUTH BOSTON MA
02127-3809
US

V. Phone/Fax

Practice location:
  • Phone: 857-799-0503
  • Fax:
Mailing address:
  • Phone: 857-799-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: