Healthcare Provider Details

I. General information

NPI: 1659982007
Provider Name (Legal Business Name): SARA S VAUGHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 08/10/2020
Certification Date: 08/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 E 2ND AVE STE 101
AURORA CO
80011-8328
US

IV. Provider business mailing address

2946 FAIRFAX ST
DENVER CO
80207-2713
US

V. Phone/Fax

Practice location:
  • Phone: 720-401-0816
  • Fax:
Mailing address:
  • Phone: 720-401-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: