Provider Demographics
NPI:1518210913
Name:VAUGHAN, JULIA ELIZABETH (MS RDN LD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MS RDN LD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ELIZABETH
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD LD
Mailing Address - Street 1:310 LEGRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:770-634-3740
Mailing Address - Fax:770-458-8640
Practice Address - Street 1:3 CLEVELAND CT
Practice Address - Street 2:SUITE E
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-354-7400
Practice Address - Fax:770-458-8640
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003981133V00000X
SC1498133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered