Provider Demographics
NPI:1942339841
Name:HOFFMANN, JUDY ANN MARIE (MSE, LPC, NCC)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN MARIE
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:MSE, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 WESTERN ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-3670
Mailing Address - Country:US
Mailing Address - Phone:920-292-4579
Mailing Address - Fax:
Practice Address - Street 1:1427 PROVINCE TER STE B
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-7016
Practice Address - Country:US
Practice Address - Phone:920-738-9999
Practice Address - Fax:920-268-1921
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2887-125101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health