Individual
BREANNA VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
N52W35634 W LAKE DR, OCONOMOWOC, WI 53066-3205
(262) 901-5881
Mailing address
N52W35634 W LAKE DR, OCONOMOWOC, WI 53066-3205
(262) 901-5881
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134436
WI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
12/18/2018
Last updated
03/05/2024
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