Individual
DR. WAYNE CARLTON ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5030 ANCHOR WAY, CHRISTIANSTED, VI 00820-4692
(340) 773-7772
Mailing address
PO BOX 26461, ST CROIX, VI 00824-2461
(340) 719-7007
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
04-019-PSY
VI
Other
Enumeration date
01/04/2007
Last updated
01/14/2020
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