Individual
MRS. SUSAN CAROLE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP, CSC
Contact information
Practice address
23 SURREY CT, COLUMBIA, SC 29212-3139
(803) 551-2900
Mailing address
23 SURREY CT, COLUMBIA, SC 29212-3139
(803) 551-2900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6196
SC
Other
Enumeration date
04/26/2006
Last updated
10/11/2019
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