Individual
AMANDA SHANNON VAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 BLACKHORSE HILL RD, COATESVILLE, PA 19320-2040
(610) 384-7711
Mailing address
1400 BLACKHORSE HILL RD, COATESVILLE, PA 19320-2040
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2232
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232
PSYCHOLOGY LICENSE
KS
Enumeration date
07/09/2009
Last updated
02/09/2018
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