Organization
SELF EMPLOYED
Active
Organization
SELF EMPLOYED
Active
Other names
Self employed
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH GAULT LICSW (CLINICIAN)
(603) 387-6636
Entity
Organization
Contact information
Practice address
6 POTTER HILL RD, GILFORD, NH 03249-6802
(603) 387-6636
Mailing address
PO BOX 1604, LACONIA, NH 03247-1604
(603) 387-6636
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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