Provider Demographics
NPI:1386256667
Name:DUGUAY, ALYSSA DAWN (MA, BCBA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:DAWN
Last Name:DUGUAY
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 E MCDOWELL RD # 175
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-7725
Mailing Address - Country:US
Mailing Address - Phone:480-478-0444
Mailing Address - Fax:602-854-7422
Practice Address - Street 1:13934 N 59TH AVE STE 160
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4168
Practice Address - Country:US
Practice Address - Phone:480-478-0444
Practice Address - Fax:602-854-7422
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-000689103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-49266OtherBCBA CERTIFICATE