Provider Demographics
NPI:1700675071
Name:THE WINGS OF DRAGONFLY LLC.
Entity type:Organization
Organization Name:THE WINGS OF DRAGONFLY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ ADDICTION COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TESKA
Authorized Official - Suffix:
Authorized Official - Credentials:CADC2
Authorized Official - Phone:678-372-3099
Mailing Address - Street 1:5555 VAUGHN RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2007
Mailing Address - Country:US
Mailing Address - Phone:678-372-3099
Mailing Address - Fax:
Practice Address - Street 1:4390 EARNEY RD STE 110
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-5687
Practice Address - Country:US
Practice Address - Phone:678-372-3099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty