Healthcare Provider Details

I. General information

NPI: 1063762094
Provider Name (Legal Business Name): KRISTI L HOFFERT LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2012
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 COBB ST
CADILLAC MI
49601-2540
US

IV. Provider business mailing address

527 COBB ST
CADILLAC MI
49601-2540
US

V. Phone/Fax

Practice location:
  • Phone: 231-775-3463
  • Fax: 231-775-1692
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801091559
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: