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General NPI Number Information
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NPI Number | 1194466193
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Entity Type | Individual
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Provider Name | TAMMY MARIE MOTT-HOFFMAN LPC
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 324 S ANDREWS ST
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City | SHAWANO
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State | WI
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Zip | 54166-2406
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Country | US
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Telephone | 715-524-4840
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Fax |
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Provider Business Mailing Address
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Address Line | W11251 SUNRISE RD
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City | GRESHAM
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State | WI
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Zip | 54128-9013
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Country | US
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Telephone | 715-853-7651
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7895-125
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License Number State | WI
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