Healthcare Provider Details

I. General information

NPI: 1104744200
Provider Name (Legal Business Name): MARIE HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12427 S PASTURE RD STE 201
RIVERTON UT
84096-5608
US

IV. Provider business mailing address

15474 S REVOLUTIONARY WAY
BLUFFDALE UT
84065-7560
US

V. Phone/Fax

Practice location:
  • Phone: 385-202-6113
  • Fax:
Mailing address:
  • Phone: 801-500-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: