Basic Information
| Provider Information | |||||||||
| NPI: | 1457763922 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOF | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | J | ||||||||
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| Mailing Information | |||||||||
| Address1: | 132 GROVE STREET | ||||||||
| Address2: | |||||||||
| City: | TORRINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067905541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604825558 | ||||||||
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| Practice Location | |||||||||
| Address1: | 132 GROVE ST | ||||||||
| Address2: | |||||||||
| City: | TORRINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067905047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604825558 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2014 | ||||||||
| LastUpdateDate: | 07/10/2017 | ||||||||
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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 | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.