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Individual

DIANE HOFSTADTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
129 PARK ST NE, SUITE 10A, VIENNA, VA 22180-4603
(405) 818-6024
Mailing address
5714 MACKENZIE ST, CENTREVILLE, VA 20120-1422
(405) 818-6024

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004826
VA
101YP2500X
Professional Counselor
1667
OK

Other

Enumeration date
10/20/2006
Last updated
10/12/2011
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