Healthcare Provider Details

I. General information

NPI: 1457183519
Provider Name (Legal Business Name): AUSTYN HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 25TH ST STE B
GRAND JUNCTION CO
81501-6561
US

IV. Provider business mailing address

1150 N 25TH ST STE B
GRAND JUNCTION CO
81501-6561
US

V. Phone/Fax

Practice location:
  • Phone: 719-460-8948
  • Fax:
Mailing address:
  • Phone: 719-460-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: