Provider Demographics
NPI:1649169707
Name:SANOU, SIBIRI IBRAHIM
Entity type:Individual
Prefix:MR
First Name:SIBIRI
Middle Name:IBRAHIM
Last Name:SANOU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 BRISTOL ST APT 3302
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3440
Mailing Address - Country:US
Mailing Address - Phone:347-932-6078
Mailing Address - Fax:
Practice Address - Street 1:1510 BRISTOL ST APT 3302
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3440
Practice Address - Country:US
Practice Address - Phone:347-932-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services