| Dedicated Dragonfly Therapy, LLC | |
|
10000 N 31st Ave Ste C100-152 Phoenix AZ 85051-1397 | |
| (602) 833-8262 | |
| (602) 883-7847 |
| Full Name | Dedicated Dragonfly Therapy, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 10000 N 31st Ave Ste C100-152, Phoenix, Arizona |
| Authorized Official Name and Position | Sylvia Anne Green (MANAGER/THERAPIST) |
| Authorized Official Contact | 6026779497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Dragonfly Therapy, LLC 11820 N 43rd Dr Glendale AZ 85304-3001 Ph: (602) 677-9497 | Dedicated Dragonfly Therapy, LLC 10000 N 31st Ave Ste C100-152 Phoenix AZ 85051-1397 Ph: (602) 833-8262 |
| NPI Number | 1962113357 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Medicare PECOS PAC ID | 2062884844 |
|---|---|
| Medicare Enrollment ID | O20230203000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962113357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | () | Primary |
| Provider Name | Sylvia Anne Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063921609 PECOS PAC ID: 4486906914 Enrollment ID: I20181011001781 |
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