Provider Demographics
NPI:1326759101
Name:ALEXIS-BRUCE, MELISSA (MFA, CPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:ALEXIS-BRUCE
Suffix:
Gender:F
Credentials:MFA, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 935
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02471-0935
Mailing Address - Country:US
Mailing Address - Phone:857-636-8873
Mailing Address - Fax:
Practice Address - Street 1:126 MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4416
Practice Address - Country:US
Practice Address - Phone:857-636-8873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator