Individual
KELLY M GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
114 COEYMAN AVE, NUTLEY, NJ 07110-1502
(631) 617-1487
Mailing address
114 COEYMAN AVE STE 206, NUTLEY, NJ 07110-1502
(631) 617-1487
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00681100
NJ
Other
Enumeration date
05/11/2017
Last updated
06/09/2021
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