Individual
THERESA VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 234-2006
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 234-2006
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
OH
172V00000X
Community Health Worker
Primary
—
OH
Other
Enumeration date
01/12/2019
Last updated
03/09/2020
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