Healthcare Provider Details

I. General information

NPI: 1396442901
Provider Name (Legal Business Name): MAHOUDO SABINE DANSOU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9982 ARBORWOOD DR APT 315
CINCINNATI OH
45251-1573
US

IV. Provider business mailing address

9982 ARBORWOOD DR APT 315
CINCINNATI OH
45251-1573
US

V. Phone/Fax

Practice location:
  • Phone: 513-344-8093
  • Fax:
Mailing address:
  • Phone: 513-344-8093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberIEWCHGQNUJ
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License NumberIEWCHGQNUJ
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: