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Individual

MS. MARJORIE EDITH GENTRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LISW

Contact information

Practice address
6330 TWO NOTCH RD, LEESVILLE, SC 29070-8216
(803) 422-2599
Mailing address
PO BOX 3122, LEESVILLE, SC 29070-1122
(803) 422-2599

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0009891
OH
1041C0700X
Clinical Social Worker
10364
SC
1041C0700X
Clinical Social Worker
Primary
I. 0009891
OH

Other

Enumeration date
07/19/2006
Last updated
01/31/2023
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