MEDICARE: MRS. JILLIAN ELISE HOFFMAN VOC. SPECIALIST

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	225400000X	Rehabilitation Practitioner	N/A

General Provider Information

NPI Number	:	1811145626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILLIAN ELISE HOFFMAN VOC. SPECIALIST

Provider Business Mailing Address
First Line	:	12101 SOUTH AVE
Second Line	:
City	:	NORTH LIMA
State	:	OH
Zip	:	44452-9742
Country	:	US
Telephone Number	:	330-549-2873
Fax Number	:

Provider Business Practice Location Address
First Line	:	12101 SOUTH AVE
Second Line	:
City	:	NORTH LIMA
State	:	OH
Zip	:	44452-9742
Country	:	US
Telephone Number	:	330-549-2873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	09/04/2008

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