Basic Information
| Provider Information | |||||||||
| NPI: | 1710290424 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRESCHER | ||||||||
| FirstName: | AIMEE | ||||||||
| MiddleName: | LOUISE ADRAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ADRAY | ||||||||
| OtherFirstName: | AIMEE | ||||||||
| OtherMiddleName: | LOUISE | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PH.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1425 STARR AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436052456 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199367738 | ||||||||
| FaxNumber: | 4199367606 | ||||||||
| Practice Location | |||||||||
| Address1: | 12623 ECKEL JUNCTION RD STE 2600 | ||||||||
| Address2: | |||||||||
| City: | PERRYSBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435511304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5673681700 | ||||||||
| FaxNumber: | 5673681478 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2010 | ||||||||
| LastUpdateDate: | 10/22/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 7427 | OH | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 23609 | CA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.