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NPI Code Detail

MEDICARE: COREY SCOTT HOLYOAK

MEDICARE:   COREY SCOTT HOLYOAK
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1861709222
Entity Type Code : Individual
Provider Name (Legal Business Name) : COREY SCOTT HOLYOAK
Provider Business Mailing Address
First Line : 1768 N WEDGEWOOD LN APT 4
Second Line :
City : CEDAR CITY
State : UT
Zip : 84721-7766
Country : US
Telephone Number : 435-531-1885
Fax Number :
Provider Business Practice Location Address
First Line : 6484 N 2300 W
Second Line :
City : CEDAR CITY
State : UT
Zip : 84721-7102
Country : US
Telephone Number : 435-867-4876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2010
Last Update Date : 09/07/2010

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Directions to “ COREY SCOTT HOLYOAK ” Practice Location

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