Provider Demographics
NPI:1043791775
Name:DUGGAN, ALYSSA KATHRYN-BREANNE
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KATHRYN-BREANNE
Last Name:DUGGAN
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 1:1424 PICKWICK LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-1274
Mailing Address - Country:US
Mailing Address - Phone:940-390-7471
Mailing Address - Fax:
Practice Address - Street 1:300 LOBO LN
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-5216
Practice Address - Country:US
Practice Address - Phone:972-947-9453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117466235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist