Shearon, Wallace Scott

Shearon, Wallace Scott is an sole proprietor health care provider with primary practice located at 565 Memorial Cir , Ormond Beach FL 32174-5001. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Shearon, Wallace Scott can be contacted via phone (386) 310-8766.

Contact Information

Primary practice address
565 Memorial Cir Ormond Beach FL 32174-5001
Phone: (386) 310-8766
Fax: (386) 310-8770
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MT1767 Florida

Profile Details

NPI number 1568422533
LBN Legal business name Shearon, Wallace Scott
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2006
Last updated Dec 16th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568422533 NPPES
Florida Other MT1767 MARRIAGE AND FAMILY THERAPIST

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