Individual
TRENT MATTHEW WIEDEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
478 S JOHNSON ST, NEW ORLEANS, LA 70112-2238
(504) 412-1580
Mailing address
478 S JOHNSON ST FL 7, NEW ORLEANS, LA 70112-2238
(504) 412-1580
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
334753
LA
Other
Enumeration date
03/24/2020
Last updated
08/08/2023
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