Healthcare Provider Details

I. General information

NPI: 1659204048
Provider Name (Legal Business Name): ELLA LUXFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 UTICA DR
WORCESTER MA
01603-1622
US

IV. Provider business mailing address

7 MYRTLE ST
GILL MA
01354-9623
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-1954
  • Fax:
Mailing address:
  • Phone: 608-692-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: