Individual
MRS. GENNIENE LYNETT DOLLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7071 STEPHENS CT, MORROW, GA 30260-3236
(404) 901-4108
Mailing address
7071 STEPHENS CT, MORROW, GA 30260-3236
(404) 901-4108
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
771094
DEFENSIVE DRIVER CERTIFICATION
GA
Enumeration date
02/25/2013
Last updated
09/03/2015
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