Provider Demographics
NPI:1639042864
Name:TABAN, VIOLA SAMMA
Entity type:Individual
Prefix:
First Name:VIOLA
Middle Name:SAMMA
Last Name:TABAN
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 1:3698 E RACQUET CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-4500
Mailing Address - Country:US
Mailing Address - Phone:385-589-4677
Mailing Address - Fax:
Practice Address - Street 1:3698 E RACQUET CLUB CIR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-4500
Practice Address - Country:US
Practice Address - Phone:385-589-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health