Provider Demographics
NPI:1902375371
Name:HOFFMANN, AMELIA (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 HERITAGE ACRES BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4457
Mailing Address - Country:US
Mailing Address - Phone:132-165-2575
Mailing Address - Fax:
Practice Address - Street 1:6251 OLD DOMINION DR
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4827
Practice Address - Country:US
Practice Address - Phone:321-652-5752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202009487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist