Provider Demographics
NPI:1083035455
Name:DREWES, ATHENA ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ATHENA
Middle Name:ANNE
Last Name:DREWES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 CRYSTAL RUN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4050
Mailing Address - Country:US
Mailing Address - Phone:845-673-4260
Mailing Address - Fax:
Practice Address - Street 1:390 CRYSTAL RUN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4050
Practice Address - Country:US
Practice Address - Phone:845-673-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011945103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent