Individual
AMANDA VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
315 E WASHINGTON ST, GREENSBORO, NC 27401-2911
(336) 387-6161
(336) 387-9167
Mailing address
902 BONNER DR, JAMESTOWN, NC 27282-8948
(336) 387-6161
(336) 387-9167
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004291
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003711
—
NC
Enumeration date
11/14/2006
Last updated
07/09/2007
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