Healthcare Provider Details

I. General information

NPI: 1093946675
Provider Name (Legal Business Name): MARY ANN HOFFMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7404 ROYAL DOMINION DR
BETHESDA MD
20817-4651
US

IV. Provider business mailing address

7404 ROYAL DOMINION DR
BETHESDA MD
20817-4651
US

V. Phone/Fax

Practice location:
  • Phone: 301-469-4831
  • Fax:
Mailing address:
  • Phone: 301-469-4831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number01143
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1097
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: