Provider Information for 1477791812
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Ms. EMILY VAUGHAN SHIERS LPC
Sex: Female
NPI: 1477791812
Last Updated: 2023-01-23
Certification Date: 2022-08-05
Certification Date: 2022-08-05
Details
Name | Value | ||||||||||||||
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NPI | 1477791812 | ||||||||||||||
Enumeration Date | 2009-01-22 | ||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||
Sole Proprietor | NO | ||||||||||||||
Status | Active | ||||||||||||||
Mailing Address | 3444 WISCONSIN AVE VICKSBURG, MS 39180-5331 United States Phone: | Fax: | ||||||||||||||
Primary Practice Address | 3444 WISCONSIN AVE VICKSBURG, MS 39180-5331 United States Phone: 601-638-0031 | Fax: | ||||||||||||||
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