Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1336688787 |
---|---|
Provider Name | Gary Bentley |
First Address | New Orleans, LA 70117-7603 |
Second Address | New Orleans, LA 70117-7603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2017 |
Last Update Date | 17/02/2017 |