Provider Demographics
NPI:1922358381
Name:HOFFMAN, KENNETH E III (BA)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:E
Last Name:HOFFMAN
Suffix:III
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:KEN
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4732 S. 131ST ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137
Mailing Address - Country:US
Mailing Address - Phone:402-697-3923
Mailing Address - Fax:402-697-3924
Practice Address - Street 1:4732 S. 131ST ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137
Practice Address - Country:US
Practice Address - Phone:402-697-3923
Practice Address - Fax:402-697-3924
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker