Individual
MICHELE LOUISE BOGRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
259 MASSACHUSETTS AVE, ARLINGTON, MA 02474-8406
(781) 643-5451
Mailing address
16 WEBBER AVE, BEDFORD, MA 01730-2213
(781) 643-5451
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3619
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
702367
TUFTS HEALTH PLAN
MA
01
—
BOWO3673
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
11/02/2006
Last updated
07/08/2007
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