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NPI Code Detail

MEDICARE: MORGAN VAUGHAN MS, LOTR

MEDICARE: MORGAN VAUGHAN MS, LOTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist300285LA

General Provider Information

NPI Number : 1669047536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN VAUGHAN MS, LOTR
Provider Business Mailing Address
First Line : 304 ACADIAN PL
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-6204
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1442 SHEPPARD ST
Second Line :
City : MINDEN
State : LA
Zip : 71055-3509
Country : US
Telephone Number : 318-377-7052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2021
Last Update Date : 05/24/2021

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Directions to “ MORGAN VAUGHAN MS, LOTR” Practice Location

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