Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 005032 | MO |
NPI | 1154430817 |
---|---|
Provider Name | Mrs. Jennifer B Hoffman |
First Address | Wentzville, MO 63385 |
Second Address | St Peters, MO 63376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 16/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
217911511 | MEDICARE AREA 99 (01) | MO |