Healthcare Provider Details

I. General information

NPI: 1881177038
Provider Name (Legal Business Name): JENNIFER LOUISE HOFFMAN DT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JENNIFER LOUISE HOFFINE

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1176 N MAIN ST
FRANKLIN IN
46131-1251
US

IV. Provider business mailing address

395 SHADOW RD
GREENWOOD IN
46142-8446
US

V. Phone/Fax

Practice location:
  • Phone: 812-343-2797
  • Fax:
Mailing address:
  • Phone: 201-916-0829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: