Provider Demographics
NPI:1326389446
Name:DRESBACK, CHRISTY FELICIDAD (MCD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:FELICIDAD
Last Name:DRESBACK
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ELAINE STREET
Mailing Address - Street 2:
Mailing Address - City:STONINGTON-(PAWCATUCK)
Mailing Address - State:CT
Mailing Address - Zip Code:06379
Mailing Address - Country:US
Mailing Address - Phone:860-961-2475
Mailing Address - Fax:
Practice Address - Street 1:28 ELAINE STREET
Practice Address - Street 2:
Practice Address - City:STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06379
Practice Address - Country:US
Practice Address - Phone:860-961-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist