Individual
HALIDA BANIISSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1876 W SERGEANT DR, SALT LAKE CITY, UT 84116-4386
(801) 637-1695
Mailing address
1876 W SERGEANT DR, SALT LAKE CITY, UT 84116-4386
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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