Provider Demographics
NPI:1871263681
Name:BIBB, SILEENA
Entity Type:Individual
Prefix:
First Name:SILEENA
Middle Name:
Last Name:BIBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23106 NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-3266
Mailing Address - Country:US
Mailing Address - Phone:216-849-1242
Mailing Address - Fax:
Practice Address - Street 1:23106 NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-3266
Practice Address - Country:US
Practice Address - Phone:216-307-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician