| Dragonfly Wellness Studio | |
|
84 Gordon Farms Rd Gorham ME 04038-2389 | |
| (207) 613-6843 | |
| (207) 419-2732 |
| Full Name | Dragonfly Wellness Studio |
|---|---|
| Speciality | Social Worker |
| Location | 84 Gordon Farms Rd, Gorham, Maine |
| Authorized Official Name and Position | Susan Elizabeth Gaudet (OWNER/FOUNDER) |
| Authorized Official Contact | 2076136843 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dragonfly Wellness Studio 84 Gordon Farms Rd Gorham ME 04038-2389 Ph: (207) 613-6843 | Dragonfly Wellness Studio 84 Gordon Farms Rd Gorham ME 04038-2389 Ph: (207) 613-6843 |
| NPI Number | 1295263762 |
|---|---|
| Provider Enumeration Date | 05/30/2017 |
| Last Update Date | 03/21/2023 |
| Certification Date | 03/21/2023 |
| Medicare PECOS PAC ID | 7214203264 |
|---|---|
| Medicare Enrollment ID | O20171019001241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295263762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC14105 (Maine) | Primary |
| Provider Name | Susan E Gaudet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902194731 PECOS PAC ID: 3173767993 Enrollment ID: I20130918000277 |
Deborah J Devine Psyd, Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Mechanic St, Gorham, ME 04038 Phone: 207-839-2450 Fax: 207-839-6469 | |
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