Provider Demographics
NPI:1245920412
Name:HOFFMANN, MELISSA (SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13568 NW 1ST LN STE 1
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3698
Mailing Address - Country:US
Mailing Address - Phone:352-331-9448
Mailing Address - Fax:352-331-9621
Practice Address - Street 1:13568 NW 1ST LN STE 1
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3698
Practice Address - Country:US
Practice Address - Phone:352-331-9448
Practice Address - Fax:352-331-9621
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist