Healthcare Provider Details

I. General information

NPI: 1205424710
Provider Name (Legal Business Name): EMILY J HOFFMAN MS, CCLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY J STEEN

II. Dates (important events)

Enumeration Date: 01/10/2021
Last Update Date: 01/10/2021
Certification Date: 01/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1348 MOORE ST
BELOIT WI
53511-4143
US

IV. Provider business mailing address

PO BOX 164
BELOIT WI
53512-0164
US

V. Phone/Fax

Practice location:
  • Phone: 262-844-8049
  • Fax: 608-207-9802
Mailing address:
  • Phone: 262-844-8049
  • Fax: 608-207-9802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: