Provider Demographics
NPI:1326100520
Name:HOFFMAN, ROCHELLE MIA (LISW)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:MIA
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 LANDMARK DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-2819
Mailing Address - Country:US
Mailing Address - Phone:864-244-0154
Mailing Address - Fax:864-609-5003
Practice Address - Street 1:161 LANDMARK DR
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2819
Practice Address - Country:US
Practice Address - Phone:864-244-0154
Practice Address - Fax:864-609-5003
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC85361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical