Individual
NANCY GENTLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2400 MARKET ST, CHARLESTOWN, IN 47111-7816
(866) 587-2172
Mailing address
4860 ROBB ST STE 201, WHEAT RIDGE, CO 80033-2162
(303) 278-7418
(888) 341-5050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002438A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34002438A
IN LICENSE BOARD
IN
Enumeration date
07/18/2017
Last updated
07/18/2017
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