MEDICARE: TATUM L MCVAUGH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-26-533428	PA

General Provider Information

NPI Number	:	1487582904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATUM L MCVAUGH

Provider Business Mailing Address
First Line	:	640 FREEDOM BUSINESS CTR DR STE 220
Second Line	:
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-1376
Country	:	US
Telephone Number	:	484-965-9966
Fax Number	:

Provider Business Practice Location Address
First Line	:	2003 LOWER STATE RD UNIT 312
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-2622
Country	:	US
Telephone Number	:	484-965-9966
Fax Number	:	484-231-8631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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