Provider Demographics
NPI:1013389006
Name:DRAGONFLY COGNITIVE DEVELOPMENT AND CONSULTING LLC
Entity Type:Organization
Organization Name:DRAGONFLY COGNITIVE DEVELOPMENT AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JANNINI
Authorized Official - Suffix:
Authorized Official - Credentials:MA ED, BCBA
Authorized Official - Phone:516-851-6213
Mailing Address - Street 1:518 FROELICH PLACE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003
Mailing Address - Country:US
Mailing Address - Phone:516-851-6213
Mailing Address - Fax:
Practice Address - Street 1:518 FROELICH PLACE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003
Practice Address - Country:US
Practice Address - Phone:516-851-6213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000759-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency