Provider Demographics
NPI:1063860989
Name:LAUZON, EMERALD (AUD)
Entity Type:Individual
Prefix:
First Name:EMERALD
Middle Name:
Last Name:LAUZON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:325 MEDICAL PKWY STE 250
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2460
Practice Address - Country:US
Practice Address - Phone:864-797-9080
Practice Address - Fax:864-797-9085
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4045237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA1681Medicaid
SC4045OtherSC LICENSE