Individual
CARLY JUDITH VANDEGRIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1000 ELMWOOD AVE STE 100, ROCHESTER, NY 14620-3042
(585) 271-0761
Mailing address
33 GANADO RD, ROCHESTER, NY 14617-5609
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
026895
NY
Other
Enumeration date
08/04/2017
Last updated
10/19/2020
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