Provider Demographics
NPI:1598333890
Name:VAUGHAN, DAVID A (COTA /L)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:VAUGHAN
Suffix:
Gender:M
Credentials:COTA /L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 ALYSA LN
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-8809
Mailing Address - Country:US
Mailing Address - Phone:469-569-4440
Mailing Address - Fax:
Practice Address - Street 1:660 ALYSA LN
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75167-8809
Practice Address - Country:US
Practice Address - Phone:469-569-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty