Provider Demographics
NPI:1326345836
Name:HARBALIEVA, NINA
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:HARBALIEVA
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 1:7828 ODYSSEUS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3503
Mailing Address - Country:US
Mailing Address - Phone:702-501-8569
Mailing Address - Fax:702-501-8569
Practice Address - Street 1:5836 S PECOS RD
Practice Address - Street 2:SUITE D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3418
Practice Address - Country:US
Practice Address - Phone:702-501-8569
Practice Address - Fax:702-501-8569
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner