Provider Demographics
NPI:1043662471
Name:SCHEARER, EMILY ANNE NICOLE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE NICOLE
Last Name:SCHEARER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 AUSTIN BROOK ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-7297
Mailing Address - Country:US
Mailing Address - Phone:860-938-5913
Mailing Address - Fax:
Practice Address - Street 1:3575 RUTHERFORD RD EXT
Practice Address - Street 2:SUITE C
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2168
Practice Address - Country:US
Practice Address - Phone:860-938-5913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9996225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist