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Individual

MS. BEVERLY ANNE VAUGHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3998 HIGHWAY 1 N, FORREST CITY, AR 72335-7637
(901) 487-5343
Mailing address
251 EVELYN RD, MARION, AR 72364-3045
(901) 487-5343

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1559
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5U970
BLUE CROSS BLUE SHIELD
AR
Enumeration date
05/21/2007
Last updated
08/22/2008
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