Individual
JENIFER LEIGH GAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
222 BIRD MOUNTAIN RIDGE RD, LANDRUM, SC 29356-9677
(864) 435-7095
Mailing address
222 BIRD MOUNTAIN RIDGE RD, LANDRUM, SC 29356-9677
(864) 435-7095
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4616
SC
Other
Enumeration date
11/26/2012
Last updated
07/07/2016
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