Provider Demographics
NPI:1033228614
Name:HOFFMAN, DENISE L (OTR/L)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 OAKLAND DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-1163
Mailing Address - Country:US
Mailing Address - Phone:269-330-2113
Mailing Address - Fax:
Practice Address - Street 1:5833 OAKLAND DR
Practice Address - Street 2:SUITE 2
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-1163
Practice Address - Country:US
Practice Address - Phone:269-330-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005647225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5201005647OtherOT ID #