Healthcare Provider Details

I. General information

NPI: 1316178593
Provider Name (Legal Business Name): KAMAREE LEIGH HOFF OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAMAREE LEIGH MAIN OTR/L

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3152 PEREGRINE NE SUITE 115
GRAND RAPIDS MI
49525
US

IV. Provider business mailing address

7762 HAVENBROOK WAY
SPRINGFIELD VA
22153-3447
US

V. Phone/Fax

Practice location:
  • Phone: 616-643-0833
  • Fax:
Mailing address:
  • Phone: 269-744-6911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119004865
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: