Provider Demographics
NPI:1386199859
Name:HERRERA, ALYSSA DUCHESNE (AUD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:DUCHESNE
Last Name:HERRERA
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 1:1208B VFW PKWY
Mailing Address - Street 2:STE 303
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4350
Mailing Address - Country:US
Mailing Address - Phone:847-663-2664
Mailing Address - Fax:
Practice Address - Street 1:1208B VFW PKWY STE 303
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4350
Practice Address - Country:US
Practice Address - Phone:617-524-3864
Practice Address - Fax:617-524-1998
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4791-SP-AU231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist