Individual
MS. OLIVIA VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4388 W VICKERY BLVD, FORT WORTH, TX 76107-6339
(817) 769-9765
Mailing address
4388 W VICKERY BLVD, FORT WORTH, TX 76107-6339
(817) 796-6765
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
126261
TX
Other
Enumeration date
06/10/2020
Last updated
12/08/2022
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