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Individual

DESTINIE VANDERGRIFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
17 W RED BANK AVE STE 103, WOODBURY, NJ 08096-1630
(856) 480-0688
Mailing address
117 SPRUCE AVE, WESTVILLE, NJ 08093-1119
(856) 625-1123

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-70926
NJ

Other

Enumeration date
07/10/2025
Last updated
07/10/2025
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