Provider Demographics
NPI:1023190790
Name:HOFSTETTER, DANA BETH (LSW, MA)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:BETH
Last Name:HOFSTETTER
Suffix:
Gender:F
Credentials:LSW, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 E 500 S
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-7859
Mailing Address - Country:US
Mailing Address - Phone:630-561-2736
Mailing Address - Fax:
Practice Address - Street 1:554 LOCUST ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5441
Practice Address - Country:US
Practice Address - Phone:219-464-3919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33005166A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker