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General NPI Number Information
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NPI Number | 1528799178
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Entity Type | Individual
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Provider Name | MAYUMI SEMBRANO VAUGHN-PATTERSON M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 16203 PANTHEON PASS
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2316
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Country | US
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Telephone | 561-450-9484
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Fax |
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Provider Business Mailing Address
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Address Line | 110 CONASKONK CIR
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-8224
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Country | US
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Telephone | 561-319-4075
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA18240
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License Number State | FL
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