Healthcare Provider Details

I. General information

NPI: 1932031911
Provider Name (Legal Business Name): JULIE LEAH VAUGHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 HIGHWAY 62 412
HIGHLAND AR
72542-9477
US

IV. Provider business mailing address

PO BOX 265
ASH FLAT AR
72513-0265
US

V. Phone/Fax

Practice location:
  • Phone: 870-856-3337
  • Fax: 870-856-3334
Mailing address:
  • Phone: 870-856-3337
  • Fax: 870-856-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberPLMSW
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: