Provider Demographics
NPI:1083161053
Name:DREHER, SIMONE
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:DREHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-1598
Mailing Address - Country:US
Mailing Address - Phone:757-224-1488
Mailing Address - Fax:757-257-0029
Practice Address - Street 1:202 CHARLOTTE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1341
Practice Address - Country:US
Practice Address - Phone:757-224-1488
Practice Address - Fax:757-224-1460
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171WV0202X
VA09040130291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171WV0202XOther Service ProvidersContractorVehicle Modifications