Provider Demographics
NPI:1366013708
Name:HOFFMAN, TIFFANY BREANNE
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:BREANNE
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 1:53 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GLEN LYON
Mailing Address - State:PA
Mailing Address - Zip Code:18617-1127
Mailing Address - Country:US
Mailing Address - Phone:570-854-8877
Mailing Address - Fax:
Practice Address - Street 1:53 N SPRING ST
Practice Address - Street 2:
Practice Address - City:GLEN LYON
Practice Address - State:PA
Practice Address - Zip Code:18617-1127
Practice Address - Country:US
Practice Address - Phone:570-854-8877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician