Individual
MRS. BETHANY POPE GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8076 NC HIGHWAY 105 S, BOONE, NC 28607-7333
(828) 963-9377
Mailing address
7849 NC HIGHWAY 194 S, BANNER ELK, NC 28604-9412
(704) 929-9751
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C010968
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C010968
LCSW
NC
Enumeration date
07/15/2015
Last updated
08/12/2019
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