Provider Demographics
NPI:1316656846
Name:FIGUEROA, XITLALI (LMT)
Entity type:Individual
Prefix:
First Name:XITLALI
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CONWAY ST APT 31
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1639
Mailing Address - Country:US
Mailing Address - Phone:857-260-8833
Mailing Address - Fax:
Practice Address - Street 1:1 CONWAY ST APT 31
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-1639
Practice Address - Country:US
Practice Address - Phone:857-260-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16495225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist