Individual
MRS. VICKI GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPASTC, MA
Contact information
Practice address
7939 CHERITON CIR, REYNOLDSBURG, OH 43068-9457
(614) 704-8820
Mailing address
7939 CHERITON CIR, REYNOLDSBURG, OH 43068-9457
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
246RP1900X
Phlebotomy Technician
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
04/04/2016
Last updated
01/08/2020
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