Provider Demographics
NPI:1295363802
Name:SAGARESE-COLEMAN, DINA (LMFT)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:SAGARESE-COLEMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7589 COURTYARD RUN W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3002
Mailing Address - Country:US
Mailing Address - Phone:954-304-6508
Mailing Address - Fax:
Practice Address - Street 1:1700 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-6504
Practice Address - Country:US
Practice Address - Phone:561-713-6872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3807106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist