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General NPI Number Information
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NPI Number | 1881894145
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Entity Type | Organization
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Legal Business Name | DOUGLAS B VAUGHAN PHD PC
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 600 SW JEFFERSON ST SUITE 206
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City | LEES SUMMIT
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State | MO
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Zip | 64063-3988
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Country | US
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Telephone | 816-554-7705
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Fax | 816-554-7706
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Provider Business Mailing Address
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Address Line | 1524 NE DEER CT
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City | LEES SUMMIT
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State | MO
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Zip | 64086-5966
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Country | US
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Telephone | 816-289-1777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS B. VAUGHAN
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Credential | PH.D.
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Telephone | 816-289-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PYR0374
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License Number State | MO
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