Healthcare Provider Details

I. General information

NPI: 1568810059
Provider Name (Legal Business Name): REBECCA MARIE HOFFMANN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA MARIE RYGWALL

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 IOWA AVE W
MARSHALLTOWN IA
50158-4768
US

IV. Provider business mailing address

101 IOWA AVE W
MARSHALLTOWN IA
50158-4768
US

V. Phone/Fax

Practice location:
  • Phone: 641-754-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number001345
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: