Individual
MR. GARDNER RAYE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LPC
Contact information
Practice address
900 SHUGART RD, DALTON, GA 30720-2467
(706) 270-5107
(706) 270-5102
Mailing address
900 SHUGART RD, DALTON, GA 30720-2467
(706) 270-5107
(706) 270-5102
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006756
GA
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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