Healthcare Provider Details

I. General information

NPI: 1457497281
Provider Name (Legal Business Name): CASEY HOFFMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4302
US

IV. Provider business mailing address

3440 MARKET ST SUITE 410
PHILADELPHIA PA
19104-3325
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-7555
  • Fax:
Mailing address:
  • Phone: 215-590-7532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS016106
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: