Individual
JENA MAREE VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1614 S BIG BEND BLVD, RICHMOND HTS, MO 63117-2208
(314) 368-1689
Mailing address
2487 HARTLAND AVE, SAINT LOUIS, MO 63114-5033
(314) 426-6702
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2010017067
MO
Other
Enumeration date
03/01/2013
Last updated
03/01/2013
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