Individual
REBECCA M. GENTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LCSW
Contact information
Practice address
60 S. STOCKWELL ROAD, EVANSVILLE, IN 47714-0247
(812) 476-5437
(812) 422-7558
Mailing address
415 MULBERRY STREET, EVANSVILLE, IN 47713-1230
(812) 423-7791
(812) 422-7558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34005896A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000645561
ANTHEM
IN
05
—
100240880
—
IN
01
—
12060881
CAQH
IN
Enumeration date
05/09/2008
Last updated
06/19/2014
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