Individual
MARY AULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 KESTREL CT, WOODSTOCK, VA 22664-2075
(520) 255-6452
Mailing address
602 KESTREL CT, WOODSTOCK, VA 22664-2075
(520) 255-6452
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
VA
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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