Provider Demographics
NPI:1619008273
Name:DRESSEL, SUSAN B (PHD)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:B
Last Name:DRESSEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7245 S KENDALL BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4662
Mailing Address - Country:US
Mailing Address - Phone:303-972-7578
Mailing Address - Fax:303-972-7578
Practice Address - Street 1:7800 S ELATI ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4483
Practice Address - Country:US
Practice Address - Phone:303-730-2079
Practice Address - Fax:303-972-7578
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0645103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07025174Medicaid