Individual
MRS. GENA HELEN CONNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1175 N BEACHVIEW DR # 133, JEKYLL ISLAND, GA 31527-0704
(478) 743-1472
Mailing address
1175 N BEACHVIEW DR # 133, JEKYLL ISLAND, GA 31527-0704
(478) 743-1472
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
GA-1253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
519934819A
—
GA
Enumeration date
02/02/2007
Last updated
02/15/2024
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