Individual
HATTIE VANDERGRIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2935 N ASHLEY ST STE 120, VALDOSTA, GA 31602-5944
(800) 832-9419
Mailing address
3121 N OAK STREET EXT, VALDOSTA, GA 31602-1099
(800) 832-9419
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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