Provider Demographics
NPI:1518578020
Name:HOFF, HOLLY A (MA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:HOFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 E PALMER WASILLA HWY STE 220
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7287
Mailing Address - Country:US
Mailing Address - Phone:907-357-6513
Mailing Address - Fax:907-357-6514
Practice Address - Street 1:1981 E PALMER WASILLA HWY STE 220
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7287
Practice Address - Country:US
Practice Address - Phone:907-357-6513
Practice Address - Fax:907-357-6514
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK172495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional