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General NPI Number Information
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NPI Number | 1972928299
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Entity Type | Individual
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Provider Name | KELLIE ANN HOFFER MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 500 WATERFRONT DR
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-5048
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Country | US
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Telephone | 401-272-5280
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CATHERINE ST
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City | PAWTUCKET
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State | RI
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Zip | 02861-3514
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Country | US
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Telephone | 401-663-8170
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP011171
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License Number State | RI
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