Healthcare Provider Details

I. General information

NPI: 1093331829
Provider Name (Legal Business Name): ANALYNDA HOFMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W ELLIOT RD STE 201
GILBERT AZ
85233-5142
US

IV. Provider business mailing address

1425 W ELLIOT RD STE 201
GILBERT AZ
85233-5142
US

V. Phone/Fax

Practice location:
  • Phone: 480-221-5391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-19017
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: