Individual
MS. GENETTE MARY PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS
Contact information
Practice address
4512 JESSIE RD, MARTINEZ, GA 30907-9759
(706) 814-6779
Mailing address
4512 JESSIE RD, MARTINEZ, GA 30907-9759
(706) 814-6779
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH 6160
FL
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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