Provider Demographics
NPI:1669632956
Name:HOFFMAN, LEE ANN
Entity Type:Individual
Prefix:MS
First Name:LEE ANN
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEE ANN
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15118 BALD EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-1500
Mailing Address - Country:US
Mailing Address - Phone:813-792-7705
Mailing Address - Fax:
Practice Address - Street 1:15118 BALD EAGLE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-1500
Practice Address - Country:US
Practice Address - Phone:813-784-0489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2147101YP2500X
NM0105391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional