Provider Demographics
NPI:1073665659
Name:HOFFMAN, JUDITH ANN (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 LINDELL BLVD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3729
Mailing Address - Country:US
Mailing Address - Phone:314-361-4227
Mailing Address - Fax:314-361-8442
Practice Address - Street 1:4625 LINDELL BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3729
Practice Address - Country:US
Practice Address - Phone:314-361-4227
Practice Address - Fax:314-361-8442
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0008781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical