| Self Employed | |
|
6 Potter Hill Rd Gilford NH 03249-6802 | |
| (603) 387-6636 | |
| Not Available |
| Full Name | Self Employed |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6 Potter Hill Rd, Gilford, New Hampshire |
| Authorized Official Name and Position | Edith Gault (CLINICIAN) |
| Authorized Official Contact | 6033876636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Employed Po Box 1604 Laconia NH 03247-1604 Ph: (603) 387-6636 | Self Employed 6 Potter Hill Rd Gilford NH 03249-6802 Ph: (603) 387-6636 |
| NPI Number | 1811677149 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 07/21/2023 |
| Certification Date | 07/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811677149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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