Provider Demographics
NPI:1558837294
Name:DRESCHER AND ASSOCIATES CLINICAL SERVICES, LLC
Entity type:Organization
Organization Name:DRESCHER AND ASSOCIATES CLINICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-505-9529
Mailing Address - Street 1:615 KINGSBURY ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1865
Mailing Address - Country:US
Mailing Address - Phone:567-218-0185
Mailing Address - Fax:419-930-6721
Practice Address - Street 1:615 KINGSBURY ST
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1865
Practice Address - Country:US
Practice Address - Phone:567-218-0185
Practice Address - Fax:419-930-6721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-21
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH393602Medicaid