Individual
ALISSA JEAN VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR HEALTH
Contact information
Practice address
105 TAYLOR DR, BYRDSTOWN, TN 38549-2414
(931) 704-5155
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912670464
—
FL
Enumeration date
01/21/2025
Last updated
01/21/2025
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