Healthcare Provider Details

I. General information

NPI: 1184996985
Provider Name (Legal Business Name): HEATHER CAROLYN HOFFER LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER CAROLYN CZUPICH LLPC

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14930 LAPLAISANCE RD
MONROE MI
48161-3880
US

IV. Provider business mailing address

3171 S GROVE DR
MONROE MI
48162-4424
US

V. Phone/Fax

Practice location:
  • Phone: 734-241-0180
  • Fax:
Mailing address:
  • Phone: 734-625-9371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401012898
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: