Individual
DR. VAUGHN ROBERT JEFFERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1030 WEST COUNTY ROAD E, STE 260, SHOREVIEW, MN 55126
(651) 483-1333
(651) 789-3088
Mailing address
1030 WEST COUNTY ROAD E, STE 260, SHOREVIEW, MN 55126
(651) 483-1333
(651) 789-3088
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1666
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
688750300
—
MN
Enumeration date
07/10/2006
Last updated
03/16/2010
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