Doctor Name: | DR. NADINE VAUGHAN |
NPI Number: | 1093756637 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | PY13578 |
Business Practice Address: | 101 E Maud St Tavares, FL - 327783249 |
Business Phone Number: | 3522539348 |
Business Fax Number: | 3522539351 |
Mailing Address: | 101 E Maud St, TAVARES |
State: | FL |
Postal Code: | 327783249 |
Phone Number: | 3522539348 |
Fax Number: | 3522539351 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 02/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY13578 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |