Provider Demographics
NPI:1629444294
Name:ZERRLAUT, ERIC DANIEL (MS)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DANIEL
Last Name:ZERRLAUT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 GRUNDY ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4343
Mailing Address - Country:US
Mailing Address - Phone:410-279-9460
Mailing Address - Fax:
Practice Address - Street 1:706 GRUNDY ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4343
Practice Address - Country:US
Practice Address - Phone:410-279-9460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional