Healthcare Provider Details

I. General information

NPI: 1235430869
Provider Name (Legal Business Name): OLYMPIA ALEXANDRA DRESZER ND, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 LONGBROOK AVE
STRATFORD CT
06614-5116
US

IV. Provider business mailing address

615 LONGBROOK AVE
STRATFORD CT
06614-5116
US

V. Phone/Fax

Practice location:
  • Phone: 203-864-4920
  • Fax:
Mailing address:
  • Phone: 203-864-4920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number000574
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number000439
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: