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Individual

MRS. AMY VAUGHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,OTR/L

Contact information

Practice address
3815 E. MAIN STREET., SUITE B, ST. CHARLES, IL 60174
(630) 584-7530
Mailing address
877 QUIN CT APT 101, NAPERVILLE, IL 60563-9293
(630) 596-3662

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008463
IL

Other

Enumeration date
09/26/2008
Last updated
02/25/2009
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