Individual
PHYLLIS GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
930 N FLOOD AVE, NORMAN, OK 73069-7642
(405) 321-3719
Mailing address
522 TRINIDAD DR, NORMAN, OK 73072-5109
(405) 928-2044
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0305
OK
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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