Provider Demographics
NPI:1003146036
Name:GENTRY, DEBRA ANN (CADC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:GENTRY
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 NW 66TH ST
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73132-7765
Mailing Address - Country:US
Mailing Address - Phone:405-834-2885
Mailing Address - Fax:
Practice Address - Street 1:600 N DEWEY AVE STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1626
Practice Address - Country:US
Practice Address - Phone:405-290-7322
Practice Address - Fax:405-290-7325
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK131001175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist