Healthcare Provider Details

I. General information

NPI: 1437184728
Provider Name (Legal Business Name): MARANGELI CRUZ HENDRICKS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 2 BOX 10553 THE VILLAGE MALL
KINGSHILL VI
00850-9604
US

IV. Provider business mailing address

PO BOX 1043
CHRISTIANSTED VI
00821-1043
US

V. Phone/Fax

Practice location:
  • Phone: 340-778-5553
  • Fax: 340-778-9497
Mailing address:
  • Phone: 340-778-5553
  • Fax: 340-778-9497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2-2017912-2006
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: