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Individual

GARY L VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
141 W 22ND ST, ANDERSON, IN 46016-4304
(765) 641-7100
Mailing address
141 W 22ND ST, ANDERSON, IN 46016-4304

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040589
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200034040
IN
Enumeration date
07/20/2006
Last updated
05/23/2022
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