Healthcare Provider Details

I. General information

NPI: 1780235879
Provider Name (Legal Business Name): HANNAH HOFFMAN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 STILES RD STE 203
SALEM NH
03079-4804
US

IV. Provider business mailing address

1 STILES RD STE 203
SALEM NH
03079-4804
US

V. Phone/Fax

Practice location:
  • Phone: 855-390-7774
  • Fax:
Mailing address:
  • Phone: 855-390-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number13205
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: