| NPI | 1487881967 |
|---|---|
| Former Name | STEPHANIE ANN GENTRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.002447) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180002447) |
| 101YP2500X Counselor, Professional | |
| 225700000X Massage Therapist (Licence: IL 227010426) | |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2023-08-18 |