Healthcare Provider Details

I. General information

NPI: 1184147977
Provider Name (Legal Business Name): TIA A HOFFER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 KALAKAUA AVE STE 206
HONOLULU HI
96815-1500
US

IV. Provider business mailing address

91-1121 KEAUNUI DR STE 108-101
EWA BEACH HI
96706-6360
US

V. Phone/Fax

Practice location:
  • Phone: 808-518-1083
  • Fax:
Mailing address:
  • Phone: 808-518-1083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1544
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: