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Organization
SAGAMORE SCHOOL, LLC
Active
Organization
SAGAMORE SCHOOL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA RACHEL GROSSMAN E.D.D., CCC-SLP (CO-OWNER)
(954) 420-9566
Entity
Organization
Contact information
Practice address
6820 LYONS TECHNOLOGY PKWY, SUITE 230, COCONUT CREEK, FL 33073-4314
(954) 420-9566
(954) 905-4382
Mailing address
6820 LYONS TECHNOLOGY CIRCLE, SUITE 230, COCONUT CREEK, FL 33073
(954) 420-9566
(954) 905-4382
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SW9748
FL
106H00000X
Marriage & Family Therapist
MT1955
FL
235Z00000X
Speech-Language Pathologist
SA10302
FL
235Z00000X
Speech-Language Pathologist
SA4869
FL
235Z00000X
Speech-Language Pathologist
Primary
SA5302
FL
235Z00000X
Speech-Language Pathologist
SA7678
FL
Other
Enumeration date
04/09/2013
Last updated
04/09/2013
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