| Diane Hofstadter, Llc | |
|
129 Park St Ne Vienna VA 22180-4603 | |
| (405) 818-6024 | |
| Not Available |
| Full Name | Diane Hofstadter, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 129 Park St Ne, Vienna, Virginia |
| Authorized Official Name and Position | Diane Hofstadter (OWNER) |
| Authorized Official Contact | 4058186024 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Hofstadter, Llc 5714 Mackenzie St Centreville VA 20120-1422 Ph: (405) 818-6024 | Diane Hofstadter, Llc 129 Park St Ne Vienna VA 22180-4603 Ph: (405) 818-6024 |
| NPI Number | 1184890378 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 10/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184890378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1667 (Oklahoma) | Primary |
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