Healthcare Provider Details

I. General information

NPI: 1558277442
Provider Name (Legal Business Name): CAROLINE ANN SANANGELO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S 5TH ST
ODESSA DE
19730-2078
US

IV. Provider business mailing address

921 WESTOWN WAY
MIDDLETOWN DE
19709-9543
US

V. Phone/Fax

Practice location:
  • Phone: 302-376-4128
  • Fax:
Mailing address:
  • Phone: 203-892-5120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number286410
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: