Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCAS-25939 | NC |
Y | 101YM0800X | Mental Health Counselor | A15918 | NC |
NPI | 1003404419 |
---|---|
Provider Name | Kristin Hoffman |
First Address | Wilmington, NC 28401-5251 |
Second Address | Wilmington, NC 28401-5251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2021 |
Last Update Date | 02/01/2021 |