Healthcare Provider Details

I. General information

NPI: 1093088817
Provider Name (Legal Business Name): REBECCA L HOFFMAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2012
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 DOCTORS PARK
SAINT CLOUD MN
56303-1207
US

IV. Provider business mailing address

107 DOCTORS PARK
SAINT CLOUD MN
56303-1207
US

V. Phone/Fax

Practice location:
  • Phone: 320-356-0308
  • Fax: 320-356-0308
Mailing address:
  • Phone: 320-356-0308
  • Fax: 320-356-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2066
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: