Provider Demographics
NPI:1699170084
Name:CHAMBERS, EMMA (OTR/L)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 WILD FLOWER LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6471
Mailing Address - Country:US
Mailing Address - Phone:843-729-8977
Mailing Address - Fax:
Practice Address - Street 1:2059 WILD FLOWER LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-6471
Practice Address - Country:US
Practice Address - Phone:843-729-8977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC341174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist