MEDICARE: ELIZABETH HANSON HOFFMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS004346-L	PA

General Provider Information

NPI Number	:	1154302669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH HANSON HOFFMAN

Provider Business Mailing Address
First Line	:	2214 MARKET ST
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-4624
Country	:	US
Telephone Number	:	717-761-8523
Fax Number	:	717-761-8525

Provider Business Practice Location Address
First Line	:	2214 MARKET ST
Second Line	:
City	:	CAMP HILL
State	:	PA
Zip	:	17011-4624
Country	:	US
Telephone Number	:	717-761-8523
Fax Number	:	717-761-8525

Authorized Official
Title or Position	:	SOLE PROPIETOR
Name	:	ELIZABETH H HOFFMAN
Credential	:	PHD
Telephone Number	:	717-761-8523

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	09/20/2007

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