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General NPI Number Information
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NPI Number | 1255082491
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Entity Type | Individual
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Provider Name | LORI VAN DRESAR LPC, CCTP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 100 COMMERCIAL CIRCLE BUILDING B-BACK ENTRANCE
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City | CONROE
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State | TX
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Zip | 77304
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Country | US
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Telephone | 832-299-4802
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Fax |
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Provider Business Mailing Address
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Address Line | 3813 COPPER MTN
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City | MONTGOMERY
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State | TX
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Zip | 77356-7937
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Country | US
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Telephone | 713-822-0054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 81900
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License Number State | TX
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