Provider Demographics
NPI:1346512670
Name:VAUGHTER, ZOE (CMT)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:VAUGHTER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-9301
Mailing Address - Country:US
Mailing Address - Phone:612-203-9633
Mailing Address - Fax:
Practice Address - Street 1:3390 COACHMAN RD STE 214
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55121-1800
Practice Address - Country:US
Practice Address - Phone:651-452-4220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist