Individual
ERIC LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1485 TEANECK RD, TEANECK, NJ 07666-3626
(201) 837-9090
Mailing address
1485 TEANECK RD APT 3B, TEANECK, NJ 07666-3626
(732) 996-5727
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00879200
NJ
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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