Basic Information
| Provider Information | |||||||||
| NPI: | 1205224227 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOFFNER | ||||||||
| FirstName: | LAURALEE | ||||||||
| MiddleName: | PUDUP | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MA, CCC-SLP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | PUDUP | ||||||||
| OtherFirstName: | LAURALEE | ||||||||
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| OtherCredential: | MA, CCC-SLP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | MC A410 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431955 | ||||||||
| FaxNumber: | 7175317269 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 HOPE DR | ||||||||
| Address2: | BUILDING B SUITE 1500 MC EC130 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175318070 | ||||||||
| FaxNumber: | 7175310138 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2014 | ||||||||
| LastUpdateDate: | 12/29/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL010371 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.