Individual
GENTRY MCMULLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1301 W GOVERNMENT ST STE 104, BRANDON, MS 39042-3196
(601) 591-7535
Mailing address
921 W BEACON ST, PHILADELPHIA, MS 39350-3229
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S-4463
MS
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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