Healthcare Provider Details

I. General information

NPI: 1245615202
Provider Name (Legal Business Name): CATHERINE HOFACKER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2149 CEDAR DR
DUNEDIN FL
34698-2516
US

IV. Provider business mailing address

2149 CEDAR DR
DUNEDIN FL
34698-2516
US

V. Phone/Fax

Practice location:
  • Phone: 727-234-5934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number16884
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: