Individual
SOU AICHA AMANDINE SANOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 SULLIVAN CIR, BELLEVUE, NE 68005-5817
(501) 410-6228
Mailing address
8102 S 90TH PLZ, LA VISTA, NE 68128-4043
(501) 410-6228
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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