Provider Demographics
NPI:1538595624
Name:LABRANCHE, GREGORY J (PHD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:LABRANCHE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 CENTRAL ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1921
Mailing Address - Country:US
Mailing Address - Phone:978-452-0042
Mailing Address - Fax:
Practice Address - Street 1:147 CENTRAL ST
Practice Address - Street 2:SUITE 209
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1921
Practice Address - Country:US
Practice Address - Phone:978-452-0042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator