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General NPI Number Information
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NPI Number | 1205226446
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Entity Type | Individual
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Provider Name | JIMMY 'JAMESON' HOLMAN LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 4190 S HIGHLAND DR STE 116
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City | MILLCREEK
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State | UT
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Zip | 84124-2668
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Country | US
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Telephone | 385-276-2796
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Fax |
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Provider Business Mailing Address
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Address Line | 4190 S HIGHLAND DR STE 116
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City | MILLCREEK
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State | UT
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Zip | 84124-2668
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Country | US
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Telephone | 385-276-2796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 9310975-3902
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License Number State | UT
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