Provider Demographics
NPI:1659623361
Name:DRESDEN, JESSICA (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:DRESDEN
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 STILLWATER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MAHTOMEDI
Mailing Address - State:MN
Mailing Address - Zip Code:55115-2060
Mailing Address - Country:US
Mailing Address - Phone:612-260-5211
Mailing Address - Fax:
Practice Address - Street 1:760 STILLWATER RD STE 101
Practice Address - Street 2:
Practice Address - City:MAHTOMEDI
Practice Address - State:MN
Practice Address - Zip Code:55115-2060
Practice Address - Country:US
Practice Address - Phone:612-260-5211
Practice Address - Fax:651-967-7251
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6055103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical