Provider Demographics
NPI:1902502651
Name:VAUGHAN, BARBARA LYNN (ATR MA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:ATR MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 N WOOLSEY AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1854
Mailing Address - Country:US
Mailing Address - Phone:479-443-4301
Mailing Address - Fax:
Practice Address - Street 1:1616 N WOOLSEY AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1854
Practice Address - Country:US
Practice Address - Phone:479-443-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist