Individual provider · Type 1 NPI

Antonio Gentry

Addiction (Substance Use Disorder) Counselor · Madras, OR

NPI number 1366149403 Active

Practice location

850 SW 4th St Ste 201
Madras, OR 97741-9629

Call (541) 475-6575 Map

Fax (541) 475-6196

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X22-05-10400 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1366149403

Antonio Gentry's National Provider Identifier is 1366149403, issued on Feb 9, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Madras, OR. The record was last updated on Feb 9, 2023.