| Provider / Organization | NPI | Date Certified |
|---|---|---|
| EMILY J HOFFMAN | 1205424710 | 2021-01-10 |
| Entity Type | Individual |
| Provider Name | Emily J Hoffman MS, CCLS |
| Other Provider Name | Emily J Steen |
| Practice Office Address | 1348 MOORE ST BELOIT, WI US |
| Practice Office Telephone | 2628448049 |
| Practice Office Fax | 6082079802 |
| Mailing Address | PO BOX 164 BELOIT, WI 535120164 US |
| Business Telephone | 2628448049 |
| Business Fax | 6082079802 |
| Simple Practice Account [] | https://emily-hoffman.clientsecure.me/ | Other Both Direct and HIE |
| Code | License No | State |
|---|---|---|
| 174400000X PRIMARY |