Individual
JERMAINE VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
233 E 84TH DR STE 205, MERRILLVILLE, IN 46410-6399
(219) 472-2062
(219) 576-6090
Mailing address
10100 ELIDA RD, DELPHOS, OH 45833-9056
(419) 695-8010
(419) 695-0004
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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