Provider Demographics
NPI:1215178819
Name:SIERRA DUCHENE, YVETTE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:SIERRA DUCHENE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5690 SANTA TERESITA DR STE A-1
Mailing Address - Street 2:
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-9206
Mailing Address - Country:US
Mailing Address - Phone:915-603-5019
Mailing Address - Fax:866-830-3399
Practice Address - Street 1:5690 SANTA TERESITA DR STE A-1
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9206
Practice Address - Country:US
Practice Address - Phone:915-603-5019
Practice Address - Fax:866-830-3399
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist