Provider Demographics
NPI:1093367336
Name:DAVIS, VAUGHN JOHNSON (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:VAUGHN
Middle Name:JOHNSON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 TULANE AVE APT 275
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6755
Mailing Address - Country:US
Mailing Address - Phone:504-296-4834
Mailing Address - Fax:
Practice Address - Street 1:4301 TULANE AVE APT 275
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6755
Practice Address - Country:US
Practice Address - Phone:504-296-4834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8400231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist