Individual
OLA JENELLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3469 LAWRENCEVILLE HWY, SUITE 103, TUCKER, GA 30084-5888
(770) 638-1960
(770) 638-1961
Mailing address
1650 PINETREE PASS LN SW, LILBURN, GA 30047
(770) 638-1960
(770) 638-1961
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
034660
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00599915E
—
GA
Enumeration date
09/14/2006
Last updated
08/10/2016
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