Healthcare Provider Details

I. General information

NPI: 1518222124
Provider Name (Legal Business Name): DANA L HOFFMAN R-LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 HUMPHREY ST
NORTH TONAWANDA NY
14120-4009
US

IV. Provider business mailing address

175 HUMPHREY ST
NORTH TONAWANDA NY
14120-4009
US

V. Phone/Fax

Practice location:
  • Phone: 716-807-3565
  • Fax: 716-807-3524
Mailing address:
  • Phone: 716-807-3565
  • Fax: 716-807-3524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: