Provider Demographics
NPI:1710261524
Name:NAVARRO, ERIC DAVID
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:DAVID
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11235 PEARTREE WAY
Mailing Address - Street 2:APT A
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4341
Mailing Address - Country:US
Mailing Address - Phone:443-472-5214
Mailing Address - Fax:
Practice Address - Street 1:11235 PEARTREE WAY
Practice Address - Street 2:APT A
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-4341
Practice Address - Country:US
Practice Address - Phone:443-472-5214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional