Individual
TIMOTHY DARRELL VUAGNIAUX
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
121 E BROADWAY BLVD, SEDALIA, MO 65301-5800
(660) 826-2380
(660) 827-6277
Mailing address
121 E BROADWAY BLVD, SEDALIA, MO 65301-5800
(660) 826-2380
(660) 827-6277
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00599
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10516013
BLUE CROSS BLUE SHIELD ID
MO
Enumeration date
08/15/2005
Last updated
07/09/2007
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