Provider Demographics
NPI:1770361404
Name:DAIGLE, SERA (CF-SLP)
Entity type:Individual
Prefix:
First Name:SERA
Middle Name:
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 COON RD
Mailing Address - Street 2:
Mailing Address - City:PIERRE PART
Mailing Address - State:LA
Mailing Address - Zip Code:70339-4718
Mailing Address - Country:US
Mailing Address - Phone:985-714-0059
Mailing Address - Fax:
Practice Address - Street 1:58030 PLAQUEMINE ST
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-2522
Practice Address - Country:US
Practice Address - Phone:225-687-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist