Provider Demographics
NPI:1619837036
Name:AZIMI, BIBI MENHAJA
Entity type:Individual
Prefix:
First Name:BIBI
Middle Name:MENHAJA
Last Name:AZIMI
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 1:170 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-4567
Mailing Address - Country:US
Mailing Address - Phone:435-713-1479
Mailing Address - Fax:435-752-6962
Practice Address - Street 1:170 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-4567
Practice Address - Country:US
Practice Address - Phone:435-713-1479
Practice Address - Fax:435-752-6962
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty