Provider Demographics
NPI:1730951260
Name:PALI, ADORA (RD, CD)
Entity type:Individual
Prefix:
First Name:ADORA
Middle Name:
Last Name:PALI
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 W 3325 N
Mailing Address - Street 2:
Mailing Address - City:FARR WEST
Mailing Address - State:UT
Mailing Address - Zip Code:84404-8632
Mailing Address - Country:US
Mailing Address - Phone:801-388-9159
Mailing Address - Fax:
Practice Address - Street 1:2841 W 3325 N
Practice Address - Street 2:
Practice Address - City:FARR WEST
Practice Address - State:UT
Practice Address - Zip Code:84404-8632
Practice Address - Country:US
Practice Address - Phone:801-388-9159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8070605-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered