1104929785 NPI number — MRS. SALOME DYANE HOFF-MCFARLANE MSW LCSW LGSW

Table of content: MRS. SALOME DYANE HOFF-MCFARLANE MSW LCSW LGSW (NPI 1104929785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104929785 NPI number — MRS. SALOME DYANE HOFF-MCFARLANE MSW LCSW LGSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFF-MCFARLANE
Provider First Name:
SALOME
Provider Middle Name:
DYANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW LCSW LGSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOFF-MCFARLANE
Provider Other First Name:
SALOME
Provider Other Middle Name:
DYANE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW LCSW LGSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1104929785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1228 7TH ST N
Provider Second Line Business Mailing Address:
MOORHEAD
Provider Business Mailing Address City Name:
MOORHEAD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56560
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-476-7816
Provider Business Mailing Address Fax Number:
701-476-7293

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 4TH ST S
Provider Second Line Business Practice Location Address:
FARGO
Provider Business Practice Location Address City Name:
FARGO
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-476-7200
Provider Business Practice Location Address Fax Number:
701-280-5795
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  3526 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 15279 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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