Healthcare Provider Details

I. General information

NPI: 1649930595
Provider Name (Legal Business Name): ANDREA MARIE HOHMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 5TH ST STE 100
AMES IA
50010-6071
US

IV. Provider business mailing address

2815 NORTHRIDGE PKWY UNIT 101
AMES IA
50010-7172
US

V. Phone/Fax

Practice location:
  • Phone: 515-233-1122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110755
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: