Basic Information
| Provider Information | |||||||||
| NPI: | 1851897904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEDGEMON | ||||||||
| FirstName: | AARON | ||||||||
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| Credential: | BA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3330 CANAL ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701196206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048272701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3330 CANAL ST | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048272701 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2018 | ||||||||
| LastUpdateDate: | 08/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225800000X | LA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Recreation Therapist | 101YM0800X | LA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.