Provider Demographics
NPI:1245872274
Name:DAVIDSON, ALYSSA J (AUD, PHD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:J
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:AUD, PHD, CCC-A
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:J
Other - Last Name:EVERETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7130 EMALY JANE LN
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5494
Mailing Address - Country:US
Mailing Address - Phone:443-987-2313
Mailing Address - Fax:
Practice Address - Street 1:1600 CRAIN HWY S STE 509
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-6443
Practice Address - Country:US
Practice Address - Phone:443-987-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01619231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist