Provider Demographics
NPI:1497283006
Name:VAUGHN, LORI (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHWICK
Mailing Address - State:MA
Mailing Address - Zip Code:01077-9666
Mailing Address - Country:US
Mailing Address - Phone:413-221-0595
Mailing Address - Fax:
Practice Address - Street 1:175 GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTHWICK
Practice Address - State:MA
Practice Address - Zip Code:01077-9666
Practice Address - Country:US
Practice Address - Phone:413-221-0595
Practice Address - Fax:413-221-0595
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002973225X00000X
MA8689225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist