Individual
MS. TISHA LEA GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LCPC
Contact information
Practice address
303 INTERNATIONAL CIR, SUITE T-125, HUNT VALLEY, MD 21030-1464
(443) 797-0144
Mailing address
203 H YORKSHIRE WAY, BEL AIR, MD 21014
(410) 420-7155
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCPC 1953
MD
101YP2500X
Professional Counselor
Primary
LC1953
MD
Other
Enumeration date
02/13/2007
Last updated
03/26/2008
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