Individual
AMANDA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 N TRAINOR AVE, MANORVILLE, NY 11949-3231
(516) 635-3084
Mailing address
17 GROVE DR, MASTIC, NY 11950-1603
(631) 466-8404
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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