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Individual

PATRICK VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CIT

Contact information

Practice address
307 HAYES ST, RAYVILLE, LA 71269-2531
(318) 728-5488
Mailing address
1135 WALLACE DEAN RD LOT 10, WEST MONROE, LA 71291-7760
(318) 307-5188

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT-4281
LA
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
05/02/2022
Last updated
05/26/2023
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