Provider Demographics
NPI:1770559247
Name:VAUGHT, AMANDA KAYE (MPT)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:KAYE
Last Name:VAUGHT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:KAYE
Other - Last Name:HELMECZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1806 N VAN BUREN ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-3851
Mailing Address - Country:US
Mailing Address - Phone:302-654-8142
Mailing Address - Fax:302-654-8143
Practice Address - Street 1:1806 N VAN BUREN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-3851
Practice Address - Country:US
Practice Address - Phone:302-654-8142
Practice Address - Fax:302-654-8143
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01158000225100000X
DEJ10001580225100000X
PAPT015139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1770559247Medicaid