Individual
PAMELA L VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2520 VALLEY DR, PT PLEASANT, WV 25550-2031
(304) 675-4340
(304) 675-5893
Mailing address
2520 VALLEY DR, PT PLEASANT, WV 25550-2031
(304) 675-4340
(304) 675-5893
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1347
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550440086
TAX IDENTIFICATION
WV
Enumeration date
12/08/2011
Last updated
12/08/2011
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