Individual
DR. CHARLES EDWARD GAUDET III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1575 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4308
(617) 876-4344
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY5000323
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/06/2021
Last updated
04/27/2023
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