Provider Demographics
NPI:1831660737
Name:ANDERSON, CHRISTIAN VAUGHAN (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIAN
Middle Name:VAUGHAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MISS
Other - First Name:CHRISTIN
Other - Middle Name:EPPS
Other - Last Name:VAUGHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:641 OLD HICKORY BLVD UNIT 45
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3950
Mailing Address - Country:US
Mailing Address - Phone:804-357-9480
Mailing Address - Fax:
Practice Address - Street 1:2208 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-5800
Practice Address - Country:US
Practice Address - Phone:615-809-2632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist