Individual
MICHELLE LAUREN DEVINCENZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7796
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
278094
MA
Other
Enumeration date
11/14/2013
Last updated
10/25/2017
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