Individual
CRYSTAL MARIE GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
200 E NORTH AVE, BALTIMORE, MD 21202-4888
(410) 396-8900
Mailing address
200 E NORTH AVE, RELATED SERVICES RM. 211, BALTIMORE, MD 21202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
06223
MD
225XP0200X
Pediatric Occupational Therapist
06223
MD
Other
Enumeration date
01/08/2009
Last updated
08/28/2019
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