Provider Demographics
NPI:1629183074
Name:HOFFMAN HAIGHT, SANDRA J (ED D)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:J
Last Name:HOFFMAN HAIGHT
Suffix:
Gender:F
Credentials:ED D
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:J
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ED D
Mailing Address - Street 1:10814 LUXBERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3505
Mailing Address - Country:US
Mailing Address - Phone:301-816-0202
Mailing Address - Fax:
Practice Address - Street 1:1700 17TH ST NW
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2419
Practice Address - Country:US
Practice Address - Phone:202-328-2283
Practice Address - Fax:202-328-2189
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1314103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC491808Medicare PIN