MEDICARE: ERIN LARTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1386268308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LARTER

Provider Business Mailing Address
First Line	:	753 S 6TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-3037
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	753 S 6TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-3037
Country	:	US
Telephone Number	:	267-516-1818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2020
Last Update Date	:	06/05/2020

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Directions to “ ERIN LARTER ” Practice Location

Language	Start Address	Practice Location

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