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NPI Code Detail

MEDICARE: MICHELLE VAUGHAN OT

MEDICARE:   MICHELLE  VAUGHAN  OT
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
1225X00000XOccupational Therapist4587AZ

General Provider Information

NPI Number : 1740329887
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE VAUGHAN OT
Provider Business Mailing Address
First Line : 5358 E BASELINE RD
Second Line :
City : MESA
State : AZ
Zip : 85206-4716
Country : US
Telephone Number : 480-699-9624
Fax Number : 480-699-8681
Provider Business Practice Location Address
First Line : 5358 E BASELINE RD
Second Line :
City : MESA
State : AZ
Zip : 85206-4716
Country : US
Telephone Number : 480-699-9624
Fax Number : 480-699-8681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 03/21/2012

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Directions to “ MICHELLE VAUGHAN OT” Practice Location

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