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Individual

DONIELLE JANECE VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11444 BEACONSFIELD ST, DETROIT, MI 48224-1133
(313) 447-6005
Mailing address
44641 BAYVIEW AVE., #24111, CLINTON TOWNSHIP, MI 48038
(313) 447-6005

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
07/19/2016
Last updated
07/19/2016
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