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1518598440
BRENDA ERIN LARSEN
STATEN ISLAND, NY
NPI
1518598440
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
252Y00000X Early Intervention Provider Agency
(Licence: NY 2720876)
Enumeration Date
2020-01-29
Last Update Date
2020-01-29
Business Address
BRENDA ERIN LARSEN
1110 SOUTH AVE STE 405
STATEN ISLAND, NY 10314-3414
Phone number: 718-556-1616
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Mailing Address
BRENDA ERIN LARSEN
9013 83RD AVE
GLENDALE, NY 11385-7815
Phone number: 718-928-8645
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