| Organization Name: | BRENDA B HOLLIS, LPC, PC |
| NPI Number: | 1407058175 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENDA B HOLLIS (OWNER) |
| Mailing Address: | 1626 Frederica Rd Suite 203 St Simons Island |
| State: | GA US |
| Postal Code: | 315222529 |
| Phone Number: | 9126380180 |
| Fax Number: | 9126380181 |
| NPI Enumeration Date: | 06/04/2007 |
| NPI Last Update Date: | 11/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC000819 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |