Provider Demographics
NPI:1164560462
Name:EMERICK, ALISON CONRAD (MS, OTR L)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:CONRAD
Last Name:EMERICK
Suffix:
Gender:F
Credentials:MS, OTR L
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:ELIZABETH
Other - Last Name:CONRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR L
Mailing Address - Street 1:233 PINECREST ST
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8008
Mailing Address - Country:US
Mailing Address - Phone:704-987-0267
Mailing Address - Fax:
Practice Address - Street 1:233 PINECREST ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8008
Practice Address - Country:US
Practice Address - Phone:704-987-0267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3120225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist