MEDICARE: MS. HILDRED C HOFFMAN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	392	KS
2	1041C0700X	Clinical Social Worker	4441	MO

General Provider Information

NPI Number	:	1285895748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HILDRED C HOFFMAN MSW

Provider Business Mailing Address
First Line	:	4844 W 138 TERR
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66224
Country	:	US
Telephone Number	:	913-345-2328
Fax Number	:	913-451-1479

Provider Business Practice Location Address
First Line	:	1278 W US HIGHWAY 40
Second Line	:
City	:	ODESSA
State	:	MO
Zip	:	64076-9612
Country	:	US
Telephone Number	:	816-633-5921
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	11/09/2015

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