Provider Demographics
NPI:1275678476
Name:WOLFSON, AARON (PHD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:WOLFSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:SUITE #223
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-780-1202
Mailing Address - Fax:504-780-1705
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:SUITE #223
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-780-1202
Practice Address - Fax:504-780-1705
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C015Medicare ID - Type Unspecified