Healthcare Provider Details

I. General information

NPI: 1790353126
Provider Name (Legal Business Name): KARLA HOFFMANN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2021
Last Update Date: 06/13/2021
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 MISSION RD
PRAIRIE VILLAGE KS
66206-1714
US

IV. Provider business mailing address

1557 CANTERBURY LN
LIBERTY MO
64068-3231
US

V. Phone/Fax

Practice location:
  • Phone: 913-735-3393
  • Fax:
Mailing address:
  • Phone: 816-719-1849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2019010664
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: