Individual
BETHANY COLAVINCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.M
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 714-4400
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 714-4400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/08/2009
Last updated
01/08/2009
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