Provider Demographics
NPI:1972277341
Name:VANDEGRIFT, ALEXANDRA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:M
Last Name:VANDEGRIFT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 S 12TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-4814
Mailing Address - Country:US
Mailing Address - Phone:484-350-3447
Mailing Address - Fax:
Practice Address - Street 1:2132 S 12TH ST STE 103
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4814
Practice Address - Country:US
Practice Address - Phone:215-837-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist