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MRS. JESSICA LAURETTE GENTRY M.S., CCC-SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1609176411

Individual Registrant:
MRS. JESSICA LAURETTE GENTRY M.S., CCC-SLP
Gender: F
Sole Proprietor

Location and contact information for practice:
58 SCOTT CT  DEFUNIAK SPRINGS, FL 32433-3560 US
Tel: 850-307-3645  Fax: --

Contact information for business:
58 SCOTT CT  DEFUNIAK SPRINGS, FL 32433-3560 US
Tel: 850-307-3645  Fax: --

Registration Information:
NPI: 1609176411
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
FLSA 9528

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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