Doctor Name: | DR. JOSEPH MICHAEL VANDERGRIFT |
NPI Number: | 1225228612 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PS01026 |
Business Practice Address: | 6 N Main St Suite 305 Uxbridge, MA - 015691871 |
Business Phone Number: | 5087698547 |
Business Fax Number: | 5082782521 |
Mailing Address: | 6 N Main St, Suite 305 UXBRIDGE |
State: | MA |
Postal Code: | 015691871 |
Phone Number: | 5087698547 |
Fax Number: | 5082782521 |
NPI Enumeration Date: | 07/31/2007 |
NPI Last Update Date: | 08/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | PS01026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |