Provider Demographics
NPI:1508669821
Name:VAUGHN, CALLIE ELIZABETH (OTR/L, CSCS)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:ELIZABETH
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:OTR/L, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SUGAR BEND CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7420
Mailing Address - Country:US
Mailing Address - Phone:618-922-0375
Mailing Address - Fax:
Practice Address - Street 1:12900 TESSON FERRY RD STE B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2908
Practice Address - Country:US
Practice Address - Phone:314-696-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025008639225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand