Provider Demographics
NPI:1407204605
Name:GRBELJA, IVANA (MS, LCGC)
Entity Type:Individual
Prefix:MISS
First Name:IVANA
Middle Name:
Last Name:GRBELJA
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 S COTTONWOOD ST BLDG 4L6
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5701
Mailing Address - Country:US
Mailing Address - Phone:801-507-4577
Mailing Address - Fax:801-442-0252
Practice Address - Street 1:5121 S COTTONWOOD ST BLDG 4L6
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5701
Practice Address - Country:US
Practice Address - Phone:801-507-4577
Practice Address - Fax:801-442-0252
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS