Individual
HEATHER M AULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6711 FOREST PARK DR, SAVANNAH, GA 31406-2507
(912) 429-8452
Mailing address
6711 FOREST PARK DR, SAVANNAH, GA 31406-2507
(912) 429-8452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/01/2018
Last updated
05/01/2018
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