Provider Demographics
NPI:1861188773
Name:HOFFMAN, MICHAELA ANNE I
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ANNE
Last Name:HOFFMAN
Suffix:I
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 1:408 W SMITH ST APT 2J
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2293
Mailing Address - Country:US
Mailing Address - Phone:207-461-1496
Mailing Address - Fax:
Practice Address - Street 1:6100 W FRIENDLY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4160
Practice Address - Country:US
Practice Address - Phone:336-369-4313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10564225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist