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General NPI Number Information
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NPI Number | 1396085635
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Entity Type | Individual
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Provider Name | ERIC HARLACHER CADCA
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Gender | Male
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Dates
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Enumeration Date | 02/24/2013
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Last Update Date | 02/24/2013
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Provider Practice Location Address
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Address Line | 65 N MADISON AVE SUITE 302
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City | PASADENA
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State | CA
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Zip | 91101-2035
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Country | US
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Telephone | 818-415-5706
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Fax |
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Provider Business Mailing Address
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Address Line | 838 IRVING DR
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City | BURBANK
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State | CA
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Zip | 91504-1833
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Country | US
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Telephone | 818-415-5706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CADCA (I3760312)
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License Number State | CA
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