Individual
MRS. CAROLINE STANLY GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8304 OLD KEENE MILL RD, SPRINGFIELD, VA 22152-1640
(314) 873-1717
Mailing address
8313 GREELEY BLVD, SPRINGFIELD, VA 22152-2905
(314) 873-1717
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701007248
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0701007248
—
VA
Enumeration date
08/30/2017
Last updated
08/30/2017
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