| Doctor Name: | MR. CLARK B. HOLLADAY |
| NPI Number: | 1437221454 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 265550-3501 |
| Business Practice Address: | 45 E 600 N Nephi, UT - 846481239 |
| Business Phone Number: | 4356601137 |
| Business Fax Number: | 4356234339 |
| Mailing Address: | Po Box 170, NEPHI |
| State: | UT |
| Postal Code: | 846480170 |
| Phone Number: | 4356601137 |
| Fax Number: | 4356234339 |
| NPI Enumeration Date: | 11/14/2006 |
| NPI Last Update Date: | 04/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 265550-3501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |