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1174047856
GREGORY H GENTRY
SHREVEPORT, LA
NPI
1174047856
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA 116)
Enumeration Date
2017-08-03
Last Update Date
2023-01-05
Business Address
Mr. GREGORY H GENTRY LAC
2000 FAIRFILED AVENUE
SHREVEPORT, LA 71104-2002
Phone number: 318-222-8511
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Mailing Address
Mr. GREGORY H GENTRY LAC
363 SANDEFUR DR
SHREVEPORT, LA 71105-3245
Phone number: 318-752-4454
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