Provider Demographics
NPI:1477781367
Name:FAULK-VAUGHAN, HILLARY ASHTON (MA, LPA, HSP-PA)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:ASHTON
Last Name:FAULK-VAUGHAN
Suffix:
Gender:F
Credentials:MA, LPA, HSP-PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6843
Mailing Address - Country:US
Mailing Address - Phone:910-794-3929
Mailing Address - Fax:910-798-2303
Practice Address - Street 1:4130 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6843
Practice Address - Country:US
Practice Address - Phone:910-794-3929
Practice Address - Fax:910-798-2303
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3719103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical