Provider Demographics
NPI:1760181978
Name:COLSON, ERIC ANTHONY
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ANTHONY
Last Name:COLSON
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 1:943 BERKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIAN ORCHARD
Mailing Address - State:MA
Mailing Address - Zip Code:01151-1373
Mailing Address - Country:US
Mailing Address - Phone:413-209-2037
Mailing Address - Fax:
Practice Address - Street 1:943 BERKSHIRE AVE
Practice Address - Street 2:
Practice Address - City:INDIAN ORCHARD
Practice Address - State:MA
Practice Address - Zip Code:01151-1373
Practice Address - Country:US
Practice Address - Phone:413-209-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty