Individual
CLARISSA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9201 W THOMAS RD, PHOENIX, AZ 85037-3332
Mailing address
11626 SWEET PEA RUN, SAN ANTONIO, TX 78245-2462
(602) 384-4081
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
I013052
AZ
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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