Healthcare Provider Details

I. General information

NPI: 1952777476
Provider Name (Legal Business Name): BRENT HOFHINES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 01/25/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 S EASTERN AVE STE 200
LAS VEGAS NV
89123-2545
US

IV. Provider business mailing address

PO BOX 370304
LAS VEGAS NV
89137-0304
US

V. Phone/Fax

Practice location:
  • Phone: 435-229-3245
  • Fax:
Mailing address:
  • Phone: 435-229-3245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5797085-3503
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8342
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: