Individual
ADAM DAVID VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7905 N MEADOWLARK WAY, COEUR D ALENE, ID 83815-5041
(208) 762-1250
Mailing address
7905 N MEADOWLARK WAY, COEUR D ALENE, ID 83815-5041
(208) 762-1250
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
03/08/2021
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