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Individual

HEATHER ANN HOFMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1058 E WORTHY ST, GONZALES, LA 70737-4302
(225) 258-7322
(225) 450-3799
Mailing address
1058 E WORTHY ST STE B-2, GONZALES, LA 70737-4302
(225) 258-7322
(225) 450-3799

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH0012108
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
81-5326332
LA
Enumeration date
11/01/2017
Last updated
11/01/2017
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