| Breanna Hoffman Therapeutic Services | |
|
4255 Pheasant Ridge Dr Ne Ste 412 Blaine MN 55449-5066 | |
| (763) 703-3755 | |
| Not Available |
| Full Name | Breanna Hoffman Therapeutic Services |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4255 Pheasant Ridge Dr Ne Ste 412, Blaine, Minnesota |
| Authorized Official Name and Position | Breanna Hoffman (CEO) |
| Authorized Official Contact | 7636703970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breanna Hoffman Therapeutic Services 2086 130th Ln Nw Coon Rapids MN 55448-7009 Ph: (763) 670-3970 | Breanna Hoffman Therapeutic Services 4255 Pheasant Ridge Dr Ne Ste 412 Blaine MN 55449-5066 Ph: (763) 703-3755 |
| NPI Number | 1215780085 |
|---|---|
| Provider Enumeration Date | 04/10/2024 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Medicare PECOS PAC ID | 0244672889 |
|---|---|
| Medicare Enrollment ID | O20240528001932 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215780085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Breanna Michelle Hoffman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1053773010 PECOS PAC ID: 1850733189 Enrollment ID: I20240531001370 |
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