Nicole Vaughn, MCD, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Harrisburg, AR

NPI 1487031316 · NPPES record last updated Feb 29, 2016

Key facts

NPI
1487031316
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
P8893 (AR)
Practice address
1606 Pine Grove LN
Harrisburg, AR 72432-9304
Phone
(870) 761-9155
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P8893ARMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X P8893 AR Yes

Addresses

Primary practice location

1606 Pine Grove LN
Harrisburg, AR 72432-9304

Mailing address

121 Harper Dr
Brookland, AR 72417-9063
Phone (870) 761-9155

Other providers in Harrisburg, AR

All providers in Harrisburg, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.