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NPI Code Detail

MEDICARE: MYA VAUGHN

MEDICARE: MYA VAUGHN
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1770409765
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYA VAUGHN
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1170
Country : US
Telephone Number : 855-324-0885
Fax Number :
Provider Business Practice Location Address
First Line : 3771 S A ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-6053
Country : US
Telephone Number : 765-598-4197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2026
Last Update Date : 06/25/2026

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Directions to “ MYA VAUGHN ” Practice Location

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