Individual
JACQUELINE GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1627 TERRY MILL RD SE, ATLANTA, GA 30316-2338
(954) 696-0673
Mailing address
1627 TERRY MILL RD SE, ATLANTA, GA 30316-2338
(954) 696-0673
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
010642
GA
Other
Enumeration date
11/23/2020
Last updated
09/14/2023
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