Provider Demographics
NPI:1629854435
Name:GAUDET, LI
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:GAUDET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:NH
Mailing Address - Zip Code:03222-3263
Mailing Address - Country:US
Mailing Address - Phone:603-744-0888
Mailing Address - Fax:
Practice Address - Street 1:119 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:NH
Practice Address - Zip Code:03222-3263
Practice Address - Country:US
Practice Address - Phone:603-744-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist