Provider Demographics
NPI:1336184282
Name:WILKENFELD, LOREN (PHD, ABPP)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:
Last Name:WILKENFELD
Suffix:
Gender:F
Credentials:PHD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61011
Mailing Address - Street 2:SOUTHEAST LOUISIANA VETERANS HEALTH CARE SYSTEM
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70161-1011
Mailing Address - Country:US
Mailing Address - Phone:504-556-7309
Mailing Address - Fax:
Practice Address - Street 1:1555 POYDRAS ST
Practice Address - Street 2:SOUTHEAST LOUISIANA VETERANS HEALTH CARE SYSTEM
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3701
Practice Address - Country:US
Practice Address - Phone:504-556-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2073103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist