Individual
AMANDA NICHOLLE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
195 MATTIE M KELLY BLVD, DESTIN, FL 32541-2811
(850) 654-4588
Mailing address
6500 N LAGOON DR, PANAMA CITY BEACH, FL 32408-3739
(620) 228-7636
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 13946
FL
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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