Healthcare Provider Details

I. General information

NPI: 1518512722
Provider Name (Legal Business Name): MISS SANIA AHMED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2019
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 E 3900 S
SALT LAKE CITY UT
84107-2182
US

IV. Provider business mailing address

3283 W JORDAN LINE PKWY APT 317
WEST JORDAN UT
84088-7970
US

V. Phone/Fax

Practice location:
  • Phone: 801-839-5360
  • Fax:
Mailing address:
  • Phone: 630-701-0686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: