Provider Demographics
NPI:1255604278
Name:JUFFER, PATRICIA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JUFFER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5813
Mailing Address - Country:US
Mailing Address - Phone:859-663-7440
Mailing Address - Fax:
Practice Address - Street 1:4325 NAKOMA RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3706
Practice Address - Country:US
Practice Address - Phone:608-271-7321
Practice Address - Fax:608-271-3946
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3637-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist