Individual
DR. ALEXIS BRANCA BANCROFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-7025
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11055
MA
Other
Enumeration date
03/19/2019
Last updated
05/23/2019
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