Provider Demographics
NPI:1245547033
Name:DE HOFF, SUSAN LARAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LARAINE
Last Name:DE HOFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 VENUS DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-1951
Mailing Address - Country:US
Mailing Address - Phone:508-845-5005
Mailing Address - Fax:
Practice Address - Street 1:330 CONCORD RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1819
Practice Address - Country:US
Practice Address - Phone:978-443-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral