Provider Demographics
NPI:1265887236
Name:HALIM, HANIYA JASMINE
Entity type:Individual
Prefix:
First Name:HANIYA
Middle Name:JASMINE
Last Name:HALIM
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 1:3740 HERITAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3187
Mailing Address - Country:US
Mailing Address - Phone:248-930-3512
Mailing Address - Fax:
Practice Address - Street 1:1582 NADINE
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4335
Practice Address - Country:US
Practice Address - Phone:248-930-3512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program