Individual
MRS. LISA BRATTON GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMFT, BCBA
Contact information
Practice address
6 PELHAM RIDGE DR, GREENVILLE, SC 29615-5935
(864) 490-1668
Mailing address
710 8TH ST, GAFFNEY, SC 29340-4801
(864) 490-1668
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-21097
SC
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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