| Clark B. Holladay, Lcsw, Lc | |
|
656 N Main St #5 Nephi UT 84648-1123 | |
| (435) 623-5044 | |
| (435) 623-5044 |
| Full Name | Clark B. Holladay, Lcsw, Lc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 656 N Main St, Nephi, Utah |
| Authorized Official Name and Position | Clark B. Holladay (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4356235044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark B. Holladay, Lcsw, Lc 656 N Main St #5 Nephi UT 84648-1123 Ph: (435) 623-5044 | Clark B. Holladay, Lcsw, Lc 656 N Main St #5 Nephi UT 84648-1123 Ph: (435) 623-5044 |
| NPI Number | 1619172806 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619172806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2655503501 (Utah) | Primary |
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