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General NPI Number Information
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NPI Number | 1487999249
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Entity Type | Organization
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Legal Business Name | WORK OF MY HANDS
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 4405 FORTUNE LN
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City | BEAUMONT
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State | TX
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Zip | 77705-4831
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Country | US
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Telephone | 409-504-0633
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Fax | 409-840-9788
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Provider Business Mailing Address
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Address Line | PO BOX 41812
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City | BEAUMONT
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State | TX
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Zip | 77725-1812
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Country | US
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Telephone | 409-504-0633
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Fax | 409-840-9788
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LAURA RUTH VAUGHN
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Credential | LBSW-IPR
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Telephone | 409-504-0633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 22408
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License Number State | TX
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