Individual
BRENDA MAE HOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 823-3952
Mailing address
4133 FOX BRUSH DR, EVANS, GA 30809-4882
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC004721
GA
104100000X
Social Worker
Primary
MSW004452
GA
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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