Healthcare Provider Details

I. General information

NPI: 1891832192
Provider Name (Legal Business Name): DAVIDA HOFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6541 SPECKER AVE
COLORADO SPRINGS CO
80913-4263
US

IV. Provider business mailing address

6541 SPECKER AVE
COLORADO SPRINGS CO
80913-4263
US

V. Phone/Fax

Practice location:
  • Phone: 719-503-7843
  • Fax:
Mailing address:
  • Phone: 719-503-7843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number992297
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: