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Individual

LAURA RUTH VAUGHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LBSW,MA

Contact information

Practice address
4405 FORTUNE LN, BEAUMONT, TX 77705-4831
(409) 842-9727
(409) 840-9788
Mailing address
P. O. BOX 41812, BEAUMONT, TEXAS 77725
(409) 842-9727
(409) 840-9788

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22408
TX

Other

Enumeration date
08/20/2012
Last updated
08/20/2012
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