Provider Demographics
NPI:1841443611
Name:BARBARA HOFMANN, PH.D., PLLC
Entity type:Organization
Organization Name:BARBARA HOFMANN, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-761-1411
Mailing Address - Street 1:3660 FOREST HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1523
Mailing Address - Country:US
Mailing Address - Phone:248-761-1411
Mailing Address - Fax:248-519-1201
Practice Address - Street 1:650 E. BIG BEAVER ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:TROYQ
Practice Address - State:MI
Practice Address - Zip Code:48083-1432
Practice Address - Country:US
Practice Address - Phone:248-761-1411
Practice Address - Fax:248-519-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007944251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI1264Medicare PIN
MIR66913Medicare UPIN