Individual
DIANE P. VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 A CENTRAL AVE, BAYARD, NM 88023-8802
(575) 537-4088
(575) 537-3921
Mailing address
PO BOX 1000, BAYARD, NM 88023-1000
(575) 537-4088
(575) 537-3921
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-A6410
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477683316
—
NM
Enumeration date
08/03/2018
Last updated
08/03/2018
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