MEDICARE: DR. LOREN WILKENFELD PH.D., ABPP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	2073	NC

General Provider Information

NPI Number	:	1336184282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOREN WILKENFELD PH.D., ABPP

Provider Business Mailing Address
First Line	:	PO BOX 61011
Second Line	:	SOUTHEAST LOUISIANA VETERANS HEALTH CARE SYSTEM
City	:	NEW ORLEANS
State	:	LA
Zip	:	70161-1011
Country	:	US
Telephone Number	:	504-556-7309
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 POYDRAS ST
Second Line	:	SOUTHEAST LOUISIANA VETERANS HEALTH CARE SYSTEM
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-3701
Country	:	US
Telephone Number	:	504-556-7309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. LOREN WILKENFELD PH.D., ABPP” Practice Location

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