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Organization

DRAGONFLY THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DANIELLE MARIE HAGGERTY (PRESIDENT)
(207) 433-7778
Entity
Organization

Contact information

Practice address
840 HAMMOND ST STE 2, BANGOR, ME 04401-4339
(207) 433-7778
(207) 433-7780
Mailing address
840 HAMMOND ST STE 2, BANGOR, ME 04401-4339
(207) 433-7778
(207) 433-7780

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040462
BLUE CROSS & BLUE SHIELD
ME
01
1668152
AETNA
ME
05
434571000
ME
01
AA65965
HARVARD PILGRIM
ME
01
DE4681
RAILROAD MEDICARE
ME
Enumeration date
02/10/2006
Last updated
02/01/2011
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