Healthcare Provider Details

I. General information

NPI: 1659332120
Provider Name (Legal Business Name): ELLEN B HOFFMAN-GOLDWASSER L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 03/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 OLD COURT RD # B SUITE 22
BALTIMORE MD
21208-3905
US

IV. Provider business mailing address

3655 OLD COURT RD # B SUITE 22
BALTIMORE MD
21208-3905
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-0389
  • Fax: 410-653-9415
Mailing address:
  • Phone: 410-486-0389
  • Fax: 410-653-9415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: