Provider Demographics
NPI:1427282458
Name:OLEFSON, ALLISON (MS)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:OLEFSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KINKAID AVE
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-2908
Mailing Address - Country:US
Mailing Address - Phone:201-767-5799
Mailing Address - Fax:
Practice Address - Street 1:25 KINKAID AVE
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-2908
Practice Address - Country:US
Practice Address - Phone:201-767-5799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYS4111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist