Basic Information
| Provider Information | |||||||||
| NPI: | 1386790392 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOFSTATTER | ||||||||
| FirstName: | RUTH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 68 WHITING LN | ||||||||
| Address2: | |||||||||
| City: | WEST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061191641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602334830 | ||||||||
| FaxNumber: | 8602316222 | ||||||||
| Practice Location | |||||||||
| Address1: | 664 PROSPECT AVE | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061054203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602334830 | ||||||||
| FaxNumber: | 8602316222 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 03-364555 | CT | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.