Provider Demographics
NPI:1407540107
Name:DUFFY, ALLISON (AUD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:DUFFY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5457 SANDHURST LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25313-1231
Mailing Address - Country:US
Mailing Address - Phone:717-514-5828
Mailing Address - Fax:
Practice Address - Street 1:500 DONNALLY ST STE 200
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1600
Practice Address - Country:US
Practice Address - Phone:681-229-3090
Practice Address - Fax:681-229-3091
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0411231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist