Provider Demographics
NPI:1912557232
Name:BIFFAR, ALLISON ZOE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ZOE
Last Name:BIFFAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IL
Mailing Address - Zip Code:62298-1572
Mailing Address - Country:US
Mailing Address - Phone:618-920-0152
Mailing Address - Fax:
Practice Address - Street 1:200 ROGERS ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298-1572
Practice Address - Country:US
Practice Address - Phone:618-920-0152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.014690235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist