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NPI Code Detail

MEDICARE: GENTRIE NOLEN M.S. CCC-SLP

MEDICARE: GENTRIE NOLEN M.S. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist113550TX

General Provider Information

NPI Number : 1720542905
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENTRIE NOLEN M.S. CCC-SLP
Provider Business Mailing Address
First Line : 2304 CALMONT DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76001-8408
Country : US
Telephone Number : 972-922-7883
Fax Number :
Provider Business Practice Location Address
First Line : 763 MARLANDWOOD RD
Second Line :
City : TEMPLE
State : TX
Zip : 76502-3573
Country : US
Telephone Number : 254-771-5950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2019
Last Update Date : 01/22/2019

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Directions to “ GENTRIE NOLEN M.S. CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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