Provider Demographics
NPI:1740606797
Name:BRATHWAITE, MIGDALIA (PH,D)
Entity type:Individual
Prefix:DR
First Name:MIGDALIA
Middle Name:
Last Name:BRATHWAITE
Suffix:
Gender:F
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:KINGSHILL
Mailing Address - State:VI
Mailing Address - Zip Code:00851-0918
Mailing Address - Country:US
Mailing Address - Phone:340-773-1311
Mailing Address - Fax:
Practice Address - Street 1:3500 RICHMOND
Practice Address - Street 2:CHRISTIANSTED
Practice Address - City:ST. CROIX
Practice Address - State:VI
Practice Address - Zip Code:00820-4370
Practice Address - Country:US
Practice Address - Phone:340-773-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling