Individual
MR. JAMES R. GENTRY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-1298
(479) 968-6053
Mailing address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 967-5570
(479) 890-5364
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P0611062
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226868719
—
AR
Enumeration date
03/21/2007
Last updated
02/06/2020
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