Provider Demographics
NPI:1417644212
Name:PIPES, HOLLY (SSW, MSW STUDENT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:PIPES
Suffix:
Gender:F
Credentials:SSW, MSW STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 N 300 W
Mailing Address - Street 2:
Mailing Address - City:MANTI
Mailing Address - State:UT
Mailing Address - Zip Code:84642-1023
Mailing Address - Country:US
Mailing Address - Phone:435-851-7515
Mailing Address - Fax:
Practice Address - Street 1:190 W 100 S
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-2531
Practice Address - Country:US
Practice Address - Phone:435-896-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
UT12841524-3503104100000X
UT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program