Provider Demographics
NPI:1336247923
Name:HOFMANN, BARBARA LEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LEE
Last Name:HOFMANN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 30TH ST
Mailing Address - Street 2:#516
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:303-449-2759
Mailing Address - Fax:303-449-6291
Practice Address - Street 1:1510 OAK AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1254
Practice Address - Country:US
Practice Address - Phone:303-449-2759
Practice Address - Fax:303-449-6291
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA136960225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31907067Medicaid
CO31907067Medicaid
CO804745Medicare ID - Type Unspecified