Individual
ROBERT ROSS GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
298 CLEAR SKY CT STE G, CLARKSVILLE, TN 37043-5685
(706) 571-7771
Mailing address
298 CLEAR SKY CT STE G, CLARKSVILLE, TN 37043-5685
(706) 571-7771
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MA110026265
—
MA
Enumeration date
08/30/2012
Last updated
08/30/2012
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