Provider Demographics
NPI:1063018943
Name:HOFFMANN, ERICA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STAFFORD ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-1457
Mailing Address - Country:US
Mailing Address - Phone:508-859-7207
Mailing Address - Fax:
Practice Address - Street 1:120 STAFFORD ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1457
Practice Address - Country:US
Practice Address - Phone:508-859-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13786225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist