Healthcare Provider Details

I. General information

NPI: 1740606797
Provider Name (Legal Business Name): MIGDALIA BRATHWAITE PH,D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 RICHMOND CHRISTIANSTED
ST. CROIX VI
00820-4370
US

IV. Provider business mailing address

PO BOX 918
KINGSHILL VI
00851-0918
US

V. Phone/Fax

Practice location:
  • Phone: 340-773-1311
  • Fax:
Mailing address:
  • Phone: 340-773-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: