Individual
MRS. ALEXIS TIERRA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMM
Contact information
Practice address
4420 BOSTIC DR APT 306, GREENVILLE, NC 27834-9423
(229) 379-8873
Mailing address
4420 BOSTIC DR APT 306, GREENVILLE, NC 27834-9423
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/24/2019
Last updated
12/23/2024
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