Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 24834 | MD |
Y | 2251H1200X | Hand | 24834 | MD |
NPI | 1265724413 |
---|---|
Provider Name | Jennifer Ann Vaughn |
First Address | Chevy Chase, MD 20815-5832 |
Second Address | Chevy Chase, MD 20815-5803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2011 |
Last Update Date | 25/11/2019 |