Healthcare Provider Details
I. General information
NPI: 1346341906
Provider Name (Legal Business Name): MARY FRAN HOFFMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/26/2006
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2865 CHANCELLOR DR SUITE 100
CRESTVIEW HILLS KY
41017-3912
US
IV. Provider business mailing address
1455 S FORT THOMAS AVE
FORT THOMAS KY
41075-2453
US
V. Phone/Fax
- Phone: 859-442-8439
- Fax: 859-781-0123
- Phone: 859-442-8439
- Fax: 859-781-0123
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 720 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: