Provider Demographics
NPI:1275248312
Name:HOFFMAN, LESLIE
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 W NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-4105
Mailing Address - Country:US
Mailing Address - Phone:231-728-3501
Mailing Address - Fax:
Practice Address - Street 1:11 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1127
Practice Address - Country:US
Practice Address - Phone:231-670-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician