Healthcare Provider Details

I. General information

NPI: 1003781881
Provider Name (Legal Business Name): ALLYSON ASHLEY FLYNN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 10TH ST
WAKEFIELD NE
68784-5014
US

IV. Provider business mailing address

230 RUSSELL RD
YANKTON SD
57078-6726
US

V. Phone/Fax

Practice location:
  • Phone: 402-287-2061
  • Fax:
Mailing address:
  • Phone: 781-689-5097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number20230009507
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: