Healthcare Provider Details

I. General information

NPI: 1053721886
Provider Name (Legal Business Name): ANDREA K DUGHOFF PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA SAATHOFF

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 09/29/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 W FORT ST CRH 2ND FLOOR
BOISE ID
83702-4535
US

IV. Provider business mailing address

850 THORNTON PL
HENDERSONVILLE NC
28791-4406
US

V. Phone/Fax

Practice location:
  • Phone: 208-422-1018
  • Fax:
Mailing address:
  • Phone: 305-772-7212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4692
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5882
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: