Provider Demographics
NPI:1740637248
Name:HOFFMAN, KORI LEIGH (MA CF-SLP)
Entity type:Individual
Prefix:
First Name:KORI
Middle Name:LEIGH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 NELA PKWY
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6849
Mailing Address - Country:US
Mailing Address - Phone:419-202-3624
Mailing Address - Fax:
Practice Address - Street 1:117 JACOB PARROT RD
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-9506
Practice Address - Country:US
Practice Address - Phone:419-674-4197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2016247-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist