Individual
JEREMY TYLER VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3606 N RANCHO DR STE 102, LAS VEGAS, NV 89130-3196
(702) 800-1929
Mailing address
3370 SAINT ROSE PKWY APT 411, HENDERSON, NV 89052-4241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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