MEDICARE: DR. MICHELLE HOFFMANN PSYD

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	101Y00000X	Counselor	2004037106	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871577387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE HOFFMANN PSYD

Provider Business Mailing Address
First Line	:	PO BOX 432
Second Line	:
City	:	STOCKTON
State	:	MO
Zip	:	65785-0432
Country	:	US
Telephone Number	:	417-276-3380
Fax Number	:	417-276-1146

Provider Business Practice Location Address
First Line	:	104 E DAVIS
Second Line	:
City	:	STOCKTON
State	:	MO
Zip	:	65785
Country	:	US
Telephone Number	:	417-276-3380
Fax Number	:	417-276-1146

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	02/03/2023

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