Provider Demographics
NPI:1720350507
Name:DREHER, LISA (MS, RDN, LDN)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:DREHER
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CHURCH ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MA
Mailing Address - Zip Code:01240-2502
Mailing Address - Country:US
Mailing Address - Phone:845-519-5962
Mailing Address - Fax:
Practice Address - Street 1:THE ULTRAWELLNESS CENTER
Practice Address - Street 2:55 PITTSFIELD RD #9
Practice Address - City:LENOX
Practice Address - State:MA
Practice Address - Zip Code:01240-0124
Practice Address - Country:US
Practice Address - Phone:413-637-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered