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1013159045
JACKIE WAYNE VAUGHN
FORT WORTH, TX
NPI
1013159045
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TX 57085)
Enumeration Date
2009-04-06
Last Update Date
2012-01-17
Business Address
Mr. JACKIE WAYNE VAUGHN LPC
3800 HULEN ST STE 150
FORT WORTH, TX 76107-7254
Phone number: 817-255-2652
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Mailing Address
Mr. JACKIE WAYNE VAUGHN LPC
3131 SANGUINET ST
FORT WORTH, TX 76107-5336
Phone number: 817-255-2652
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