Individual
MR. MICHAEL SIBILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 SAMFORD AVE, SHREVEPORT, LA 71103-4239
(318) 222-5704
Mailing address
9000 W WILDERNESS WAY APT 202, SHREVEPORT, LA 71106-6844
(337) 351-0713
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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