Provider Demographics
NPI:1750755203
Name:HOFFMAN, DOMINIQUE
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DOMINIQUE
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NUTRITION COUNSELOR
Mailing Address - Street 1:7117 TERRY LN
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1843
Mailing Address - Country:US
Mailing Address - Phone:170-363-9706
Mailing Address - Fax:
Practice Address - Street 1:140 LITTLE FALLS ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4323
Practice Address - Country:US
Practice Address - Phone:703-639-7063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator