Individual
ALISHA GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8001 S US HIGHWAY 75, SHERMAN, TX 75090-5707
(806) 632-2098
Mailing address
5507 101ST PL, LUBBOCK, TX 79424-6289
(806) 632-2098
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
112303
TX
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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