Provider Demographics
NPI:1740485333
Name:VAUGHN, EMILY GAIL (MS OTR)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:GAIL
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:GAIL
Other - Last Name:SCHETTENHELM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR
Mailing Address - Street 1:5546 LONE EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3544
Mailing Address - Country:US
Mailing Address - Phone:303-520-7734
Mailing Address - Fax:
Practice Address - Street 1:1855 PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2325
Practice Address - Country:US
Practice Address - Phone:303-520-7734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO227539225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist