Healthcare Provider Details
I. General information
NPI: 1730740119
Provider Name (Legal Business Name): RACHAEL LYNN HOFFMAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/26/2019
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 S BRADDOCK AVE UNIT 1
PITTSBURGH PA
15218-1251
US
IV. Provider business mailing address
1435 MACON AVE
PITTSBURGH PA
15218-1220
US
V. Phone/Fax
- Phone: 412-206-9153
- Fax:
- Phone: 724-813-3399
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | PS018792 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: