Healthcare Provider Details

I. General information

NPI: 1205539947
Provider Name (Legal Business Name): HOFFMANN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3668 W 2000 N
REXBURG ID
83440-3176
US

IV. Provider business mailing address

3668 W 2000 N
REXBURG ID
83440-3176
US

V. Phone/Fax

Practice location:
  • Phone: 208-356-7355
  • Fax:
Mailing address:
  • Phone: 208-356-7355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID HOFFMANN
Title or Position: MANAGER / MEMBER
Credential:
Phone: 208-356-7355