Healthcare Provider Details

I. General information

NPI: 1225941164
Provider Name (Legal Business Name): DARLENA BIRCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 50TH PL NE
WASHINGTON DC
20019-5542
US

IV. Provider business mailing address

821 50TH PL NE
WASHINGTON DC
20019-5542
US

V. Phone/Fax

Practice location:
  • Phone: 314-458-7050
  • Fax:
Mailing address:
  • Phone: 314-458-7050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1073684
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: