Individual
NICKERIA FEARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4320 FALLS OAKS ST, MYRTLE BEACH, SC 29579-4684
(954) 305-3646
Mailing address
4320 FALLS OAKS ST, MYRTLE BEACH, SC 29579-4684
(954) 305-3646
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
SC
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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