Healthcare Provider Details

I. General information

NPI: 1750097523
Provider Name (Legal Business Name): SE'MAJ HOLIDAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 02/18/2025
Certification Date: 02/07/2023
Deactivation Date: 06/10/2024
Reactivation Date: 02/18/2025

III. Provider practice location address

1800 N STAR RD APT C1
COLUMBUS OH
43212-1503
US

IV. Provider business mailing address

1800 N STAR RD APT C1
COLUMBUS OH
43212-1503
US

V. Phone/Fax

Practice location:
  • Phone: 614-806-6374
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: