Provider Demographics
NPI:1821196452
Name:HOFFMAN, MICHELE LATRICE (MS,CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LATRICE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MS,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16362 FAIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-2133
Mailing Address - Country:US
Mailing Address - Phone:630-673-8918
Mailing Address - Fax:815-609-3764
Practice Address - Street 1:16362 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-2133
Practice Address - Country:US
Practice Address - Phone:630-673-8918
Practice Address - Fax:815-609-3764
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist