Healthcare Provider Details

I. General information

NPI: 1336875608
Provider Name (Legal Business Name): JESSICA HOFFA MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 COMMONWEALTH DR STE 100
CHARLOTTESVILLE VA
22901-1894
US

IV. Provider business mailing address

15586 SPOTSWOOD TRL
RUCKERSVILLE VA
22968-3347
US

V. Phone/Fax

Practice location:
  • Phone: 434-812-4009
  • Fax:
Mailing address:
  • Phone: 434-466-1466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0704014967
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: