Individual
MRS. PONZA A VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
507 WALNUT ST, CAMDEN, SC 29020-3649
(803) 432-9300
(803) 432-9307
Mailing address
507 WALNUT ST, CAMDEN, SC 29020-3649
(803) 432-9300
(803) 432-9307
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
742
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1713
—
SC
Enumeration date
07/21/2006
Last updated
05/15/2008
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