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NPI Code Detail

MEDICARE: MRS. DIANA HOFSTETTER LPC

MEDICARE: MRS. DIANA HOFSTETTER LPC
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
1101YM0800XMental Health Counselor74867TX

General Provider Information

NPI Number : 1174030357
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANA HOFSTETTER LPC
Provider Business Mailing Address
First Line : 804 S TEXAS AVE
Second Line :
City : BRYAN
State : TX
Zip : 77803-3946
Country : US
Telephone Number : 979-361-9851
Fax Number :
Provider Business Practice Location Address
First Line : 804 S TEXAS AVE
Second Line :
City : BRYAN
State : TX
Zip : 77803-3946
Country : US
Telephone Number : 979-361-9851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2018
Last Update Date : 01/09/2018

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Directions to “ MRS. DIANA HOFSTETTER LPC” Practice Location

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