Healthcare Provider Details

I. General information

NPI: 1902511959
Provider Name (Legal Business Name): SASHA SIBERT BISCHOFF MS, LDN, CNS, CHHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/13/2023
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 TAYLOR ST NW
WASHINGTON DC
20011-5509
US

IV. Provider business mailing address

1433 TAYLOR ST NW
WASHINGTON DC
20011-5509
US

V. Phone/Fax

Practice location:
  • Phone: 301-602-1411
  • Fax:
Mailing address:
  • Phone: 301-602-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX5824
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: