Provider Demographics
NPI:1750116927
Name:HOFFMAN, JENNIFER LYN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MUNROE FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:MUNROE FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44262-1538
Mailing Address - Country:US
Mailing Address - Phone:330-801-7148
Mailing Address - Fax:
Practice Address - Street 1:36 MUNROE FALLS AVE
Practice Address - Street 2:
Practice Address - City:MUNROE FALLS
Practice Address - State:OH
Practice Address - Zip Code:44262-1538
Practice Address - Country:US
Practice Address - Phone:234-703-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0800512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional