Individual
MRS. LISA MARIE VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 N MAIN ST, ENTERPRISE, AL 36330-2539
(334) 379-4033
Mailing address
402 LASSITER ST, OPP, AL 36467-1306
(334) 343-6474
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-334220
AL
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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