Provider Demographics
NPI:1033463443
Name:FLOYD, JESSICA SCHUMPERT (MSP, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SCHUMPERT
Last Name:FLOYD
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2993 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3421
Mailing Address - Country:US
Mailing Address - Phone:803-939-0026
Mailing Address - Fax:
Practice Address - Street 1:2993 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-3421
Practice Address - Country:US
Practice Address - Phone:803-939-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4953235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist