Individual
RONALD GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LPC
Contact information
Practice address
3019 E 5TH ST, TULSA, OK 74104-3106
(918) 720-4506
Mailing address
20476 E 47TH ST S, BROKEN ARROW, OK 74014-8825
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4075
OK
101YP2500X
Professional Counselor
Primary
4075
OK
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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