Individual
EVA VANDEGRIFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSCP
Contact information
Practice address
31 HEATH ST, JAMAICA PLAIN, MA 02130-1650
(617) 523-6400
(617) 824-5936
Mailing address
31 HEATH ST, JAMAICA PLAIN, MA 02130-1650
(617) 523-6400
(617) 824-5936
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303414
—
MA
Enumeration date
09/22/2014
Last updated
09/22/2014
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