Provider Demographics
NPI:1235337577
Name:HOFFERTH, BETHANY LYNCH (MED)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LYNCH
Last Name:HOFFERTH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 AMBERVIEW CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8932
Mailing Address - Country:US
Mailing Address - Phone:803-312-5340
Mailing Address - Fax:
Practice Address - Street 1:10 MEDICAL PARK RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6864
Practice Address - Country:US
Practice Address - Phone:803-898-8888
Practice Address - Fax:803-343-0727
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health