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Individual
KENNETH A VAUGHN JR.
Active
Individual
KENNETH A VAUGHN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RC CADC I CRM QMHA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
RC00052879
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08-06-73
OR
171M00000X
Case Manager/Care Coordinator
QMHA
OR
Other
Enumeration date
12/11/2006
Last updated
11/16/2012
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