Individual
LISA ELAINE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3506 PROFESSIONAL CIR STE B, MARTINEZ, GA 30907-8234
(706) 210-8855
Mailing address
3506 PROFESSIONAL CIR STE B, MARTINEZ, GA 30907-8234
(706) 210-8855
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009971
GA
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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