Healthcare Provider Details

I. General information

NPI: 1770050593
Provider Name (Legal Business Name): AARON S BERENSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 S CARROLLTON AVE UNIT B
NEW ORLEANS LA
70118-2946
US

IV. Provider business mailing address

1921 S CARROLLTON AVE UNIT B
NEW ORLEANS LA
70118-2946
US

V. Phone/Fax

Practice location:
  • Phone: 208-585-1922
  • Fax:
Mailing address:
  • Phone: 208-585-1922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: