Organization
H. NOELLE VAUGHN, MS, OTR/L LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER NOELLE VAUGHN MS, OTR/L (OWNER)
(970) 222-4620
Entity
Organization
Contact information
Practice address
7282 MOUNT MEEKER RD, LONGMONT, CO 80503-7126
(970) 222-4620
Mailing address
7282 MOUNT MEEKER RD, LONGMONT, CO 80503-7126
(970) 222-4620
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT.0004164
CO
225XP0200X
Pediatric Occupational Therapist
Primary
OT.0004164
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003211939
NPI
CO
05
—
48731765
—
CO
Enumeration date
10/14/2016
Last updated
06/15/2021
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