Provider Demographics
NPI:1801010962
Name:HOFF, SHERRY DENISE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:DENISE
Last Name:HOFF
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7452 BROOK LOOP
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-6917
Mailing Address - Country:US
Mailing Address - Phone:701-870-5632
Mailing Address - Fax:
Practice Address - Street 1:7452 BROOK LOOP
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-6917
Practice Address - Country:US
Practice Address - Phone:701-870-5632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1801010962Medicaid