Provider Demographics
NPI:1326221169
Name:GENTRY, RACHEL HELEN (MA, MS)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:HELEN
Last Name:GENTRY
Suffix:
Gender:F
Credentials:MA, MS
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:HELEN
Other - Last Name:GENTRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1806 W ROYALE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-2243
Mailing Address - Country:US
Mailing Address - Phone:765-381-4578
Mailing Address - Fax:765-252-1316
Practice Address - Street 1:1806 W ROYALE DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2243
Practice Address - Country:US
Practice Address - Phone:765-381-4578
Practice Address - Fax:765-252-1316
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health