Provider Demographics
NPI:1770826281
Name:FESTA-DREHER, DESAREE VALERIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DESAREE
Middle Name:VALERIE
Last Name:FESTA-DREHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:DESAREE
Other - Middle Name:VALERIE
Other - Last Name:DREHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6060 PIEDMONT ROW SOUTH
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28287
Mailing Address - Country:US
Mailing Address - Phone:704-552-0116
Mailing Address - Fax:704-552-7550
Practice Address - Street 1:6060 PIEDMONT ROW SOUTH
Practice Address - Street 2:SUITE 120
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28287
Practice Address - Country:US
Practice Address - Phone:704-552-0116
Practice Address - Fax:704-552-7550
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4422103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist