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NPI Code Detail

MEDICARE: OPHELIA ANN HOLIDAY CSW

MEDICARE: OPHELIA ANN HOLIDAY CSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker14265101-3502UT

General Provider Information

NPI Number : 1750226411
Entity Type Code : Individual
Provider Name (Legal Business Name) : OPHELIA ANN HOLIDAY CSW
Provider Business Mailing Address
First Line : 30 W MEDICAL DR
Second Line :
City : MONUMENT VALLEY
State : UT
Zip : 84536-7705
Country : US
Telephone Number : 435-459-1135
Fax Number :
Provider Business Practice Location Address
First Line : 30 W MEDICAL DR
Second Line :
City : MONUMENT VALLEY
State : UT
Zip : 84536-7705
Country : US
Telephone Number : 435-459-1135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2026
Last Update Date : 04/21/2026

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Directions to “ OPHELIA ANN HOLIDAY CSW” Practice Location

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