Individual
HOLLY R EARL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 FOOTHILL DR, #112, SLC, UT 84108-2327
(801) 759-0101
Mailing address
PO BOX 71736, SALT LAKE CITY, UT 84171-0736
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
133518-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278803
DMBA
UT
01
—
76636
PEHP
UT
Enumeration date
11/17/2006
Last updated
07/08/2007
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