Provider Demographics
NPI:1881407310
Name:HOFF, MIRANDA (BA)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:HOFF
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5004 ELK RIVER RD S
Mailing Address - Street 2:
Mailing Address - City:ELKVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25071-9619
Mailing Address - Country:US
Mailing Address - Phone:304-759-9835
Mailing Address - Fax:
Practice Address - Street 1:5004 ELK RIVER RD S
Practice Address - Street 2:
Practice Address - City:ELKVIEW
Practice Address - State:WV
Practice Address - Zip Code:25071-9619
Practice Address - Country:US
Practice Address - Phone:304-759-9835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health