Healthcare Provider Details

I. General information

NPI: 1528656220
Provider Name (Legal Business Name): RACHEL HOFFMAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 N 7TH ST STE 450
PHOENIX AZ
85014-3851
US

IV. Provider business mailing address

4650 N CENTRAL AVE UNIT 370
PHOENIX AZ
85012-1086
US

V. Phone/Fax

Practice location:
  • Phone: 602-997-2880
  • Fax:
Mailing address:
  • Phone: 847-977-9131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17370
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: