Individual
SAMANTHA M VANDERGRIFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
7901 E 88TH ST, INDIANAPOLIS, IN 46256-1235
(317) 849-5437
(317) 436-8911
Mailing address
7901 E 88TH ST, INDIANAPOLIS, IN 46256-1235
(317) 849-5437
(317) 436-8911
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-17-7763
IN
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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