Most Relevant Information
Provider Data
| NPI Number: | 1003181439 |
| Provider Name: | RENEE LEE GAUTHIER LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 116643 |
Most Important Dates
| Enumeration Date: | 03/19/2012 |
| Last Updated: | 03/19/2012 |
Provider Practice Location
5 BLACKBURN CTR
GLOUCESTER
MA
019302259
Practice Location Phone/Fax
| Phone: | 9782811750 |
| Fax: | 9782821354 |
Provider Mailing Location
5 BLACKBURN CTR
GLOUCESTER
MA
019302259
Provider Mailing Phone/Fax
| Phone: | 9782811750 |
| Fax: | 9782821354 |