Provider Demographics
NPI:1063060044
Name:SCHAUMBURG PERQUE, FLORENCE ANNE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:ANNE
Last Name:SCHAUMBURG PERQUE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:ANNE
Other - Last Name:SCHAUMBURG PERQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:501 W SAINT MARY BLVD STE 514A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4699
Mailing Address - Country:US
Mailing Address - Phone:337-356-2356
Mailing Address - Fax:
Practice Address - Street 1:501 W SAINT MARY BLVD STE 514A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4699
Practice Address - Country:US
Practice Address - Phone:337-356-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty