Individual
MS. CRYSTAL TINA VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2181 AMBLESIDE DR, CLEVELAND, OH 44106-4645
(216) 791-2968
Mailing address
733 E 128TH ST, CLEVELAND, OH 44108-2447
(216) 799-2191
(216) 791-2968
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 04906
OH
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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