Provider Demographics
NPI:1447930649
Name:PERRIN, SANQUENETTA
Entity type:Individual
Prefix:
First Name:SANQUENETTA
Middle Name:
Last Name:PERRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-2735
Mailing Address - Country:US
Mailing Address - Phone:864-992-7552
Mailing Address - Fax:
Practice Address - Street 1:1608 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-8006
Practice Address - Country:US
Practice Address - Phone:864-941-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3749235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist