Individual
JONATHAN BRUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1419 BEACON ST, SUITE 13, BROOKLINE, MA 02446-4808
(617) 277-4300
Mailing address
1419 BEACON ST, SUITE 13, BROOKLINE, MA 02446-4808
(617) 277-4300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3293
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
398011
HARVARD PILGRIM HLTH CARE
MA
01
—
W03401
BLUE CROSS
MA
Enumeration date
05/18/2006
Last updated
07/08/2007
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