Healthcare Provider Details

I. General information

NPI: 1245114081
Provider Name (Legal Business Name): GWENYTH HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 FRYE FARM RD
GREENSBURG PA
15601-6480
US

IV. Provider business mailing address

106 MAPLE DR
LIGONIER PA
15658-8745
US

V. Phone/Fax

Practice location:
  • Phone: 724-804-5621
  • Fax:
Mailing address:
  • Phone: 724-787-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPSL002965
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: