Provider Demographics
NPI:1891148342
Name:CLIFFORD-HOFFMAN, LESLIE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:CLIFFORD-HOFFMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-0848
Mailing Address - Country:US
Mailing Address - Phone:860-810-9897
Mailing Address - Fax:
Practice Address - Street 1:21 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3409
Practice Address - Country:US
Practice Address - Phone:860-810-9897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst