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1912555103
SOPHIA VAUGHN
LAGRANGE, GA
NPI
1912555103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171W00000X Contractor
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-08-30
Last Update Date
2019-08-30
Business Address
Mrs. SOPHIA VAUGHN
122 GORDON COMMERCIAL DR STE C
LAGRANGE, GA 30240-5754
Phone number: 706-845-4054
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Mailing Address
Mrs. SOPHIA VAUGHN
122 GORDON COMMERCIAL DR STE C
LAGRANGE, GA 30240-5754
Phone number: 706-845-4054
Copy