Provider Demographics
NPI:1417053430
Name:HOFFMAN, LAINIE RABIN (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAINIE
Middle Name:RABIN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 W INDUSTRIAL PARK DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-2635
Mailing Address - Country:US
Mailing Address - Phone:812-333-6640
Mailing Address - Fax:812-333-6640
Practice Address - Street 1:2536 W INDUSTRIAL PARK DR
Practice Address - Street 2:SUITE 7
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-2635
Practice Address - Country:US
Practice Address - Phone:812-333-6640
Practice Address - Fax:812-333-6640
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003932A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist