Provider Demographics
NPI:1063719029
Name:GRESSON, AARON DAVID III (PHD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:DAVID
Last Name:GRESSON
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9775 MILL CENTRE DR
Mailing Address - Street 2:APT. 435
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3881
Mailing Address - Country:US
Mailing Address - Phone:443-465-6724
Mailing Address - Fax:
Practice Address - Street 1:5900 YORK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3041
Practice Address - Country:US
Practice Address - Phone:410-433-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-27
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical