Provider Demographics
NPI:1669684999
Name:HEFFERAN, ALISON G (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:G
Last Name:HEFFERAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 PENN LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-5673
Mailing Address - Country:US
Mailing Address - Phone:610-431-6743
Mailing Address - Fax:
Practice Address - Street 1:200 YALE AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1918
Practice Address - Country:US
Practice Address - Phone:610-938-9000
Practice Address - Fax:610-938-9886
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006190L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019299240001Medicaid