Healthcare Provider Details

I. General information

NPI: 1962327973
Provider Name (Legal Business Name): AARON THOMAS DRETSCH LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 GRAYSTONE PLZ APT 309 119 GREY STONE PLAZA 309
DETROIT LAKES MN
56501
US

IV. Provider business mailing address

119 GRAYSTONE PLZ APT 309
DETROIT LAKES MN
56501-3053
US

V. Phone/Fax

Practice location:
  • Phone: 218-234-8871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number30669819
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: