Healthcare Provider Details

I. General information

NPI: 1992850200
Provider Name (Legal Business Name): JUDITH A. LYTEL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 NORTH RD SUITE 2380
SUDBURY MA
01776-1156
US

IV. Provider business mailing address

144 NORTH RD SUITE 2380
SUDBURY MA
01776-1156
US

V. Phone/Fax

Practice location:
  • Phone: 978-273-1542
  • Fax:
Mailing address:
  • Phone: 978-273-1542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7152
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: