Individual
DEANNA VAUGHN VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
10301 MAYO DR, BARLING, AR 72923-1660
(479) 494-5760
(479) 484-8142
Mailing address
4253 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4593
(479) 521-5731
(479) 521-6520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1241-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06070021300
QUALCHOICE
AR
01
—
5Y300
BLUE CROSS
AR
Enumeration date
07/01/2006
Last updated
07/08/2007
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