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General NPI Number Information
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NPI Number | 1144089129
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Entity Type | Individual
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Provider Name | CHARLES KEVIN VAUGHN
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Gender | Male
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 7211 HALEY INDUSTRIAL DR STE 1
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City | NOLENSVILLE
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State | TN
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Zip | 37135-9513
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Country | US
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Telephone | 615-437-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 102 ANDY JOHNS CT
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City | SMYRNA
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State | TN
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Zip | 37167-7205
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | TN
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