Provider Demographics
NPI:1306888409
Name:HOLLIS, THOMAS G (EDD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:HOLLIS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10297
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31412-0497
Mailing Address - Country:US
Mailing Address - Phone:912-713-5425
Mailing Address - Fax:912-234-4868
Practice Address - Street 1:3025 BULL ST STE 227
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-2016
Practice Address - Country:US
Practice Address - Phone:912-236-3712
Practice Address - Fax:912-236-0755
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA905103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist