Individual
MISS STEPHANIE AMBER GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA, TCADC
Contact information
Practice address
1169 EASTERN PKWY STE 1124, LOUISVILLE, KY 40217-1462
(502) 309-9751
Mailing address
1169 EASTERN PKWY STE 1124, LOUISVILLE, KY 40217-1462
(502) 509-4185
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
243711
KY
101YP2500X
Professional Counselor
Primary
246633
KY
Other
Enumeration date
04/10/2019
Last updated
12/11/2019
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