Provider Demographics
NPI:1942661780
Name:HOFFMAN, SARA BROOKE (OT/L)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:BROOKE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 HICKORY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-5434
Mailing Address - Country:US
Mailing Address - Phone:410-570-3355
Mailing Address - Fax:
Practice Address - Street 1:1525 HICKORY WOOD DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21409-5434
Practice Address - Country:US
Practice Address - Phone:410-570-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05658225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist