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General NPI Number Information
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NPI Number | 1275814311
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Entity Type | Individual
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Provider Name | ANNA-THERESE VAUGHAN MA
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Gender | Female
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 2738 E 00 NS
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City | KOKOMO
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State | IN
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Zip | 46901-6631
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Country | US
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Telephone | 765-236-1964
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Fax | 765-236-1960
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Provider Business Mailing Address
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Address Line | 2738 E 00 NS
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City | KOKOMO
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State | IN
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Zip | 46901-6631
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Country | US
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Telephone | 765-236-1964
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Fax | 765-236-1960
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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