Provider Demographics
NPI:1386143675
Name:KAUFFMAN, HEATHER (SLP)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:
Last Name:KAUFFMAN
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 1:711 E PASSYUNK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3016
Mailing Address - Country:US
Mailing Address - Phone:267-423-3715
Mailing Address - Fax:
Practice Address - Street 1:2 FRANKLIN TOWN BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1238
Practice Address - Country:US
Practice Address - Phone:267-423-3715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist