Individual
MR. GREGORY H GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2000 FAIRFILED AVENUE, SHREVEPORT, LA 71104-2002
(318) 222-8511
Mailing address
363 SANDEFUR DR, SHREVEPORT, LA 71105-3245
(318) 752-4454
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
116
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116
ADDICTIVE DISORDER REGULATORY AUTHORITY
LA
Enumeration date
08/03/2017
Last updated
01/05/2023
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