Provider Demographics
NPI:1174298103
Name:BUTLER, HOLLY ELIZABETH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ELIZABETH
Last Name:BUTLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10577 S SUNSHOWER WAY
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-6564
Mailing Address - Country:US
Mailing Address - Phone:931-237-6566
Mailing Address - Fax:
Practice Address - Street 1:10577 S SUNSHOWER WAY
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-6564
Practice Address - Country:US
Practice Address - Phone:931-237-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-18847104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker