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Contact Information

BRADLEY D GAULT, MA
98 LIBERTY LN
MINERAL WELLS, WV26150-1605
 Phone: 304-482-2959
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRADLEY D GAULT · (Male)

NPI # 1316396062
Status Active
Credentials MA
Entity Individual
Enumeration date 06/03/2016
Last updated 06/03/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • WV License # 859
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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