Provider Demographics
| NPI: | 1619598810 |
|---|---|
| Name: | DICKENS SANOMI CORP |
| Entity type: | Organization |
| Organization Name: | DICKENS SANOMI CORP |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | THERAPY MANAGER |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | EURYDICE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | DEJEAN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 954-306-3914 |
| Mailing Address - Street 1: | 6820 W SUNRISE BLVD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PLANTATION |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33313-4570 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-732-6715 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 6820 W SUNRISE BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | PLANTATION |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33313-4570 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 713-732-6715 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-04-29 |
| Last Update Date: | 2023-10-16 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities | Group - Multi-Specialty |
| No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
| No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | Group - Multi-Specialty |
| No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School | Group - Multi-Specialty |
| No | 163WS0200X | Nursing Service Providers | Registered Nurse | School | Group - Multi-Specialty |
| No | 224ZF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Feeding, Eating & Swallowing | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |