Provider Demographics
NPI:1548762933
Name:DUCKWORTH, ALANNA BUCKLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALANNA
Middle Name:BUCKLEY
Last Name:DUCKWORTH
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 1:27893 TURKEY BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-6639
Mailing Address - Country:US
Mailing Address - Phone:601-618-1066
Mailing Address - Fax:
Practice Address - Street 1:1701 N ALSTON ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2246
Practice Address - Country:US
Practice Address - Phone:251-943-2781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4043235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist