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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BRADLEY DEAN GAULT, MA

Active Sole Proprietor

BRADLEY DEAN GAULT, MA is a Child, Clinical Psychologist healthcare provider located in MINERAL WELLS, West Virginia. NPI 1316396062 is currently active in the NPPES registry. Verify at CMS.

Child, Clinical Psychologist · MINERAL WELLS, WV

Registration Details

NPI Number
1316396062
Provider Type
Individual
Gender
Male
NPI Issued
Jun 3, 2016 (10.227035336299 yrs)
Last Updated
Jun 3, 2016
License
859 (WV)
Sole Proprietor
Yes

Practice Information

Address
98 LIBERTY LN
MINERAL WELLS, WV, 261501605
Browse WV providers · Browse ZIP 26150
Phone
3044822959
Primary Specialty
Child, Clinical Psychologist
103TC2200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.