Provider Demographics
NPI:1144667015
Name:VAUGHAN, TONYA MICHELLE
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:MICHELLE
Last Name:VAUGHAN
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 1:212 SOUTH DEARBORN STREET
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602
Mailing Address - Country:US
Mailing Address - Phone:251-689-0564
Mailing Address - Fax:
Practice Address - Street 1:212 SOUTH DEARBORN STREET
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602
Practice Address - Country:US
Practice Address - Phone:251-689-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist