Individual
MRS. JENNIFER BASLER VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1 SAINT ANTHONYS WAY, ALTON, IL 62002-4568
(618) 465-2571
Mailing address
23 FAIRWAY EST, GRANITE CITY, IL 62040-6541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009513
IL
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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