Provider Demographics
NPI:1053638221
Name:DRESCHER, STUART R (PHD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:R
Last Name:DRESCHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 S 700 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1138
Mailing Address - Country:US
Mailing Address - Phone:801-483-2714
Mailing Address - Fax:801-483-3010
Practice Address - Street 1:77 S 700 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1138
Practice Address - Country:US
Practice Address - Phone:801-483-2714
Practice Address - Fax:801-483-3010
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT115822-2501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist