Provider Demographics
NPI:1700117702
Name:HOFFMAN, MARY ELLEN (OT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELLEN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 OLENTANGY RIVER RD.
Mailing Address - Street 2:STE 3200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3153
Mailing Address - Country:US
Mailing Address - Phone:614-366-4263
Mailing Address - Fax:614-366-1814
Practice Address - Street 1:915 OLENTANGY RIVER RD.
Practice Address - Street 2:STE 3200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3153
Practice Address - Country:US
Practice Address - Phone:614-366-4263
Practice Address - Fax:614-366-1814
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.005289225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist