Healthcare Provider Details

I. General information

NPI: 1225404361
Provider Name (Legal Business Name): LAURIE HOFFMAN MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 COLLEGE ST
MEDFORD WI
54451-2027
US

IV. Provider business mailing address

540 COLLEGE ST
MEDFORD WI
54451-2027
US

V. Phone/Fax

Practice location:
  • Phone: 715-748-3332
  • Fax: 715-748-3342
Mailing address:
  • Phone: 715-748-3332
  • Fax: 715-748-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1733
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: