Individual
SHARON T GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
120 LAKESIDE DR, UNION, SC 29379-1939
(864) 429-1735
Mailing address
120 LAKESIDE DR, UNION, SC 29379-1939
(864) 429-1735
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
630
SC
Other
Enumeration date
04/23/2013
Last updated
04/23/2013
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