Provider Demographics
NPI:1760984975
Name:VAUGHAN, GALE LUDWIG (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:LUDWIG
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N CENTRAL EXPY STE 900
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5326
Mailing Address - Country:US
Mailing Address - Phone:972-235-9155
Mailing Address - Fax:972-421-1833
Practice Address - Street 1:100 N CENTRAL EXPY STE 900
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5326
Practice Address - Country:US
Practice Address - Phone:972-235-9155
Practice Address - Fax:972-421-1833
Is Sole Proprietor?:No
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist