Healthcare Provider Details

I. General information

NPI: 1780757559
Provider Name (Legal Business Name): BARBARA HOFMANN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E BIG BEAVER RD STE A
TROY MI
48083-1432
US

IV. Provider business mailing address

650 E BIG BEAVER RD STE A
TROY MI
48083-1432
US

V. Phone/Fax

Practice location:
  • Phone: 248-761-1411
  • Fax: 248-519-1201
Mailing address:
  • Phone: 248-761-1411
  • Fax: 248-519-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: