Individual
JACQUE KAREN GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1445 E RIO RD, CHARLOTTESVILLE, VA 22901-1751
(866) 866-9277
Mailing address
55 BEATTIE PL STE 8, GREENVILLE, SC 29601-2165
(864) 420-6068
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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