Individual
REGINA W HOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
411 BAINBRIDGE ST, BAINBRIDGE, GA 39819-5074
(229) 220-5786
Mailing address
PO BOX 7057, BAINBRIDGE, GA 39818-7057
(229) 220-5786
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC006306
GA
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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