=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962327973
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AARON THOMAS DRETSCH LADC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2026
-----------------------------------------------------
Last Update Date | 08/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 119 GRAYSTONE PLZ APT 309 119 GREY STONE PLAZA 309
-----------------------------------------------------
City | DETROIT LAKES
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-234-8871
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 119 GRAYSTONE PLZ APT 309
-----------------------------------------------------
City | DETROIT LAKES
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56501-3053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 30669819
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------