Provider Demographics
NPI:1225375710
Name:VAUGHNS, PATRICIA (LSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:VAUGHNS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 W WASHINGTON AVE APT 2068
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4324
Mailing Address - Country:US
Mailing Address - Phone:702-234-9846
Mailing Address - Fax:
Practice Address - Street 1:7401 W WASHINGTON AVE APT 2068
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4324
Practice Address - Country:US
Practice Address - Phone:702-234-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5295-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker