Healthcare Provider Details

I. General information

NPI: 1740346907
Provider Name (Legal Business Name): PATRICIA KAY HOFFMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 SUTTON BLVD
SAINT LOUIS MO
63143-3012
US

IV. Provider business mailing address

2918 SUTTON BLVD
SAINT LOUIS MO
63143-3012
US

V. Phone/Fax

Practice location:
  • Phone: 314-644-1806
  • Fax: 314-646-1809
Mailing address:
  • Phone: 314-644-1806
  • Fax: 314-646-1809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number01621
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: