Provider Demographics
NPI:1053409524
Name:HOFFMAN, LISA KAY (OTR/L)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:KAY
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 MUDDY CREEK FORKS RD
Mailing Address - Street 2:
Mailing Address - City:AIRVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17302-9463
Mailing Address - Country:US
Mailing Address - Phone:717-927-8437
Mailing Address - Fax:
Practice Address - Street 1:3995 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2773
Practice Address - Country:US
Practice Address - Phone:717-757-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA001795225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007266430007Medicaid