MEDICARE: AUDREY ROSE HOFF

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	224Z00000X	Occupational Therapy Assistant	2024035270	MO

General Provider Information

NPI Number	:	1902623390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY ROSE HOFF

Provider Business Mailing Address
First Line	:	7818 NEW CHURCH RD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-9660
Country	:	US
Telephone Number	:	573-508-7879
Fax Number	:

Provider Business Practice Location Address
First Line	:	7915 NEW CHURCH RD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65101-9667
Country	:	US
Telephone Number	:	573-680-5592
Fax Number	:

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

Provider Enumeration Date	:	09/25/2024
Last Update Date	:	12/08/2025

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