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1609506864
ETHAN VAUGHN
DETROIT, MI
NPI
1609506864
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6851114171)
Enumeration Date
2022-06-12
Last Update Date
2022-06-12
Business Address
ETHAN VAUGHN
3646 MOUNT ELLIOTT ST
DETROIT, MI 48207-2311
Phone number: 313-331-3435
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Mailing Address
ETHAN VAUGHN
2126 LAKEVIEW DR APT 200
YPSILANTI, MI 48198-6729
Phone number:
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