Organization
DRAGONFLY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLE DUVALLE LMHC (OWNER, THERAPIST)
(352) 727-8102
Entity
Organization
Contact information
Practice address
3463 NW 13TH ST STE C, GAINESVILLE, FL 32609-2172
(352) 727-8102
Mailing address
2518 NW 51ST PL, GAINESVILLE, FL 32605-1240
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016249000
—
FL
Enumeration date
02/21/2018
Last updated
02/21/2018
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