Provider Demographics
NPI:1174912588
Name:BELALIA, HENIA
Entity type:Individual
Prefix:
First Name:HENIA
Middle Name:
Last Name:BELALIA
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 1:1191 N 1500 W
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116-1672
Mailing Address - Country:US
Mailing Address - Phone:510-529-8927
Mailing Address - Fax:
Practice Address - Street 1:1191 N 1500 W
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-1672
Practice Address - Country:US
Practice Address - Phone:510-529-8927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter