Individual
JULAINE FAYE GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHEMICAL DEPENDENCY
Contact information
Practice address
211 4TH ST, EAST CENTRAL MHICD CENTER INC, BROOKINGS, SD 57006
(605) 697-2850
(605) 697-2874
Mailing address
211 4TH ST, EAST CENTRAL MHICD CENTER INC, BROOKINGS, SD 57006
(605) 697-2850
(605) 697-2874
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5200060
—
SD
Enumeration date
05/05/2008
Last updated
05/05/2008
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