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General NPI Number Information
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NPI Number | 1427266790
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Entity Type | Individual
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Provider Name | VICKIE LYN HOFFMAN OTR
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Gender | Female
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Dates
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Enumeration Date | 05/19/2007
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 7804 W COLLEGE DR STE 1SW
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1060
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Country | US
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Telephone | 708-923-1332
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Fax |
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Provider Business Mailing Address
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Address Line | 1658 HEATHER DR
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City | MUNSTER
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State | IN
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Zip | 46321-3906
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Country | US
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Telephone | 219-924-8999
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056.006968
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 31000383A
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License Number State | IN
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