Individual
GLENN VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
416 E FOSTER AVE, 2488 MERRITT CREEK LOOP SUITE NUMBER 2C, COEUR D ALENE, ID 83814-3045
(208) 659-3931
Mailing address
416 E FOSTER AVE, COEUR D ALENE, ID 83814-3045
(208) 659-3931
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC-5394
ID
Other
Enumeration date
01/20/2015
Last updated
01/20/2015
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