Provider Demographics
NPI:1770322661
Name:SANAULLAH, ZALA
Entity type:Individual
Prefix:MISS
First Name:ZALA
Middle Name:
Last Name:SANAULLAH
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 1:1343 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-5311
Mailing Address - Country:US
Mailing Address - Phone:801-232-7633
Mailing Address - Fax:801-466-2377
Practice Address - Street 1:1343 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5311
Practice Address - Country:US
Practice Address - Phone:801-232-7633
Practice Address - Fax:801-466-2377
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator