Provider Demographics
NPI:1275999781
Name:HOFMAN, CLAIRE TERESA
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:TERESA
Last Name:HOFMAN
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 1:8154 PRINCE CHARMING LN
Mailing Address - Street 2:
Mailing Address - City:ROSCOE
Mailing Address - State:IL
Mailing Address - Zip Code:61073-8136
Mailing Address - Country:US
Mailing Address - Phone:815-505-9500
Mailing Address - Fax:
Practice Address - Street 1:8154 PRINCE CHARMING LN
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-8136
Practice Address - Country:US
Practice Address - Phone:815-505-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist