Provider Demographics
NPI:1326175282
Name:HOFER, KATHLEEN SLADE (MAPC, CPCE)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:SLADE
Last Name:HOFER
Suffix:
Gender:F
Credentials:MAPC, CPCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N 800 W
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042-1729
Mailing Address - Country:US
Mailing Address - Phone:801-785-2938
Mailing Address - Fax:
Practice Address - Street 1:1255 N 1200 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2445
Practice Address - Country:US
Practice Address - Phone:801-229-1181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT108694-6010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health