Individual
TIFFANY VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WILSON LOOP, WARD, AR 72176
(501) 941-5630
Mailing address
1500 WILSON LOOP, WARD, AR 72176-8656
(501) 588-3211
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2030
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159501721
—
AR
01
—
5Y668
BLUE CROSS BLUE SHEILD
AR
Enumeration date
02/26/2007
Last updated
08/02/2016
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