| Kathryn Vaughn Llc | |
|
3160 Main St Ste 102 Duluth GA 30096-3461 | |
| (470) 426-5281 | |
| Not Available |
| Full Name | Kathryn Vaughn Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3160 Main St Ste 102, Duluth, Georgia |
| Authorized Official Name and Position | Kathryn Irene Vaughn (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4704265281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn Vaughn Llc 3968 Mainsail Ct Duluth GA 30096-5281 Ph: (678) 557-0934 | Kathryn Vaughn Llc 3160 Main St Ste 102 Duluth GA 30096-3461 Ph: (470) 426-5281 |
| NPI Number | 1083270227 |
|---|---|
| Provider Enumeration Date | 05/14/2019 |
| Last Update Date | 10/18/2019 |
| Medicare PECOS PAC ID | 9638409246 |
|---|---|
| Medicare Enrollment ID | O20190925000661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083270227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn Vaughn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245701044 PECOS PAC ID: 9234461401 Enrollment ID: I20191022000869 |
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