Healthcare Provider Details

I. General information

NPI: 1942270384
Provider Name (Legal Business Name): LAURA M HOFFMAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA M HOFFMAN

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 A PASEO DE ONATE SUITE L
ESPANOLA NM
87532
US

IV. Provider business mailing address

933 BRADBURY DR SE STE 2222
ALBUQUERQUE NM
87106-4375
US

V. Phone/Fax

Practice location:
  • Phone: 505-852-1377
  • Fax: 505-852-1378
Mailing address:
  • Phone: 505-272-3120
  • Fax: 505-272-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801094761
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801094761
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: