Individual
MOLLY E GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M/SLP
Contact information
Practice address
1226 AMBLING WAY DR, MYRTLE BEACH, SC 29579-7524
(443) 604-7943
Mailing address
1226 AMBLING WAY DR, MYRTLE BEACH, SC 29579-7524
(443) 604-7943
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20200846
VA
235Z00000X
Speech-Language Pathologist
6861
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4978218
—
VA
Enumeration date
12/22/2015
Last updated
02/06/2025
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