Provider Demographics
NPI:1164869236
Name:DRESNER, MOLLY RAI (SLP-CCC)
Entity Type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:RAI
Last Name:DRESNER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:MISS
Other - First Name:MOLLY
Other - Middle Name:RAI
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP-CCC
Mailing Address - Street 1:336 E 81ST ST
Mailing Address - Street 2:APT 2A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-3948
Mailing Address - Country:US
Mailing Address - Phone:301-775-3446
Mailing Address - Fax:
Practice Address - Street 1:336 E 81ST ST
Practice Address - Street 2:APT 2A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-3948
Practice Address - Country:US
Practice Address - Phone:301-775-3446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023735-1235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist