Provider Demographics
NPI:1013051952
Name:DREHER, KATHLEEN D
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:D
Last Name:DREHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HIGH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-1237
Mailing Address - Country:US
Mailing Address - Phone:860-599-3833
Mailing Address - Fax:
Practice Address - Street 1:14 MASONS ISLAND RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2958
Practice Address - Country:US
Practice Address - Phone:860-536-3078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000253231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist