Larson, Eric

Larson, Eric is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Larson, Eric can be contacted via phone (414) 955-0660.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 955-0660
Fax: (414) 955-0076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2808 Wisconsin
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2808 Wisconsin

Profile Details

NPI number 1386763902
LBN Legal business name Larson, Eric
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Jul 10th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386763902 NPPES
Wisconsin MEDICAID 1386763902
Wisconsin MEDICAID 071006762

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