Provider Demographics
NPI:1861656027
Name:INSALACO, BRIE A (PHD)
Entity Type:Individual
Prefix:
First Name:BRIE
Middle Name:A
Last Name:INSALACO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1368 BEACON ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2872
Mailing Address - Country:US
Mailing Address - Phone:617-959-1010
Mailing Address - Fax:617-323-3734
Practice Address - Street 1:1368 BEACON ST
Practice Address - Street 2:SUITE 116
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-2872
Practice Address - Country:US
Practice Address - Phone:617-959-1010
Practice Address - Fax:617-323-3734
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist