Healthcare Provider Details

I. General information

NPI: 1356756043
Provider Name (Legal Business Name): JACQUELINE SCARANGELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2014
Last Update Date: 06/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3411 SILVERSIDE RD SPRINGER BUILDING, SUITE 105
WILMINGTON DE
19810-4812
US

IV. Provider business mailing address

204 WELDIN RD
WILMINGTON DE
19803-4934
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-5240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO1-0001195
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: