Provider Demographics
NPI:1740719186
Name:HOLLIE, MONETIA
Entity type:Individual
Prefix:MRS
First Name:MONETIA
Middle Name:
Last Name:HOLLIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 WESLEY CHAPEL RD UNIT 361151
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30036-2343
Mailing Address - Country:US
Mailing Address - Phone:404-474-1627
Mailing Address - Fax:404-474-8937
Practice Address - Street 1:2724 WESLEY CHAPEL ROAD, #361151
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30036
Practice Address - Country:US
Practice Address - Phone:404-474-1627
Practice Address - Fax:404-474-8937
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator