Provider Demographics
NPI:1619318904
Name:DRESCHER, CHRISTOPHER FOX (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:FOX
Last Name:DRESCHER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 WALTON WAY, SUITE 1400
Mailing Address - Street 2:ATTN: DONNA RAIFORD
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901
Mailing Address - Country:US
Mailing Address - Phone:706-828-8401
Mailing Address - Fax:706-722-7235
Practice Address - Street 1:997 SAINT SEBASTIAN WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-2613
Practice Address - Country:US
Practice Address - Phone:706-446-0058
Practice Address - Fax:706-721-3593
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004009103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent