Individual
DANETTE J GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W LYON DR, NEOSHO, MO 64850-9194
(615) 896-6400
Mailing address
310 HIGHWAY F, ANDERSON, MO 64831-9813
(918) 314-1182
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005022
MO
224Z00000X
Occupational Therapy Assistant
—
—
Other
Enumeration date
06/06/2007
Last updated
06/25/2024
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