Healthcare Provider Details

I. General information

NPI: 1033585245
Provider Name (Legal Business Name): LESLIE ZEBROWITZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 SOUTH ST BRANDEIS UNIVERSITY DEPARTMENT OF PSYCHOLOGY MS 062
WALTHAM MA
02453-2728
US

IV. Provider business mailing address

DEPARTMENT OF PSYCHOLOGY MS 062 BRANDEIS UNIVERSITY
WALTHAM MA
02454-9110
US

V. Phone/Fax

Practice location:
  • Phone: 781-736-3263
  • Fax: 781-736-3291
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: