Individual
MELISSA VAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 SOUTH BLVD, 310, VIRGINIA BEACH, VA 23452-1160
(757) 490-3223
Mailing address
635 GRAYDON AVE, APT. 6, NORFOLK, VA 23507-1737
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004411
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004979907
—
VA
Enumeration date
04/19/2007
Last updated
07/08/2007
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