Healthcare Provider Details

I. General information

NPI: 1487137923
Provider Name (Legal Business Name): DEBBIE K HOFHINES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4460 S HIGHLAND DR STE 300
SALT LAKE CITY UT
84124-3562
US

IV. Provider business mailing address

4460 S HIGHLAND DR STE 300
SALT LAKE CITY UT
84124-3562
US

V. Phone/Fax

Practice location:
  • Phone: 888-949-4864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number3103306-3503
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: