Provider Demographics
NPI:1619546256
Name:DUCHARME, ALAYNA (RBT)
Entity Type:Individual
Prefix:
First Name:ALAYNA
Middle Name:
Last Name:DUCHARME
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34251 STATE HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:PIASA
Mailing Address - State:IL
Mailing Address - Zip Code:62079-2528
Mailing Address - Country:US
Mailing Address - Phone:618-402-1323
Mailing Address - Fax:
Practice Address - Street 1:7674 PLUMMER BUSINESS DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294-7604
Practice Address - Country:US
Practice Address - Phone:314-275-0506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILBACB686303106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician