Provider Demographics
NPI:1467174656
Name:DRAGONFLY MARRIAGE AND FAMILY COUNSELING OF SAN DIEGO INC.
Entity Type:Organization
Organization Name:DRAGONFLY MARRIAGE AND FAMILY COUNSELING OF SAN DIEGO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-627-1887
Mailing Address - Street 1:1855 1ST AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2650
Mailing Address - Country:US
Mailing Address - Phone:619-627-1887
Mailing Address - Fax:619-415-8198
Practice Address - Street 1:1855 1ST AVE STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2650
Practice Address - Country:US
Practice Address - Phone:619-627-1887
Practice Address - Fax:619-415-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty