Provider Demographics
NPI:1780495044
Name:VAUGHN, LASHAUNDA DELORES
Entity type:Individual
Prefix:
First Name:LASHAUNDA
Middle Name:DELORES
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10979 REED HARTMAN HWY STE 227
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2882
Mailing Address - Country:US
Mailing Address - Phone:513-745-0396
Mailing Address - Fax:513-672-2823
Practice Address - Street 1:10979 REED HARTMAN HWY STE 227
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2882
Practice Address - Country:US
Practice Address - Phone:513-745-0396
Practice Address - Fax:513-672-2823
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC54340224900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty