Individual
SUSAN M VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
7700 FRANCE AVE S STE 240, EDINA, MN 55435-5878
(763) 201-8191
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-2684
(763) 201-8191
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
100119
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263999800
—
MN
Enumeration date
08/16/2006
Last updated
05/13/2021
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