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General NPI Number Information
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NPI Number | 1871133967
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Entity Type | Individual
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Provider Name | SANDRA DIMARCO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 1035 S STATE ROAD 7 # 315-25
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City | WELLINGTON
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State | FL
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Zip | 33414-6134
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Country | US
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Telephone | 561-320-3493
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Fax |
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Provider Business Mailing Address
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Address Line | 192 SW 60TH AVE
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City | PLANTATION
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State | FL
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Zip | 33317-3461
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3216
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License Number State | FL
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