Individual
KRYSTAL VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
870 N MILITARY HWY STE 208, NORFOLK, VA 23502-3638
(757) 627-1530
Mailing address
870 N MILITARY HWY STE 208, NORFOLK, VA 23502-3638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701008568
VA
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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