Most Relevant Information
Provider Data
| NPI Number: | 1003517988 |
| Provider Name: | SEPHORA B SIDIBE BAMBA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/16/2023 |
| Last Updated: | 06/27/2023 |
Provider Practice Location
1818 NEW YORK AVE NE
WASHINGTON
DC
200021848
Practice Location Phone/Fax
| Phone: | 2028006440 |
| Fax: | 2028996994 |
Provider Mailing Location
1818 NEW YORK AVE NE
WASHINGTON
DC
200021848
Provider Mailing Phone/Fax
| Phone: | 2028006440 |
| Fax: | 2028996994 |