Provider Demographics
NPI:1205912235
Name:DREISBACH, VICTORIA MARIE (DO)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIE
Last Name:DREISBACH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 SILVER ST.
Mailing Address - Street 2:WHITING FORENSIC DIVISION, D1S
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457
Mailing Address - Country:US
Mailing Address - Phone:860-262-5000
Mailing Address - Fax:860-262-5965
Practice Address - Street 1:1 SILVER ST.
Practice Address - Street 2:WHITING FORENSIC DIVISION, D1S
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457
Practice Address - Country:US
Practice Address - Phone:860-262-5000
Practice Address - Fax:860-262-5965
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0385312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry