Healthcare Provider Details

I. General information

NPI: 1033378526
Provider Name (Legal Business Name): FRANCES PALMER HOLLIDAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 07/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 SE MARTIN AVE
STUART FL
34996-1213
US

IV. Provider business mailing address

135 SE MARTIN AVE
STUART FL
34996-1213
US

V. Phone/Fax

Practice location:
  • Phone: 772-341-3431
  • Fax:
Mailing address:
  • Phone: 772-341-3431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW8921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: