Provider Demographics
NPI:1588053201
Name:HOFFMAN, JUDITH (BCABA)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-9606
Mailing Address - Country:US
Mailing Address - Phone:856-982-1724
Mailing Address - Fax:
Practice Address - Street 1:250 HADDONFIELD BERLIN RD
Practice Address - Street 2:
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1228
Practice Address - Country:US
Practice Address - Phone:856-346-0005
Practice Address - Fax:856-784-1799
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0-13-5324103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst