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NPI Code Detail

MEDICARE: KELLEY H. AHR PSY.D

MEDICARE:   KELLEY H. AHR  PSY.D
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
1103T00000XPsychologist30541TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578670998
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY H. AHR PSY.D
Provider Business Mailing Address
First Line : 2403 W.BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78704
Country : US
Telephone Number : 512-707-2782
Fax Number :
Provider Business Practice Location Address
First Line : 2403 W BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78704-7534
Country : US
Telephone Number : 512-707-2782
Fax Number : 512-707-2783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 03/25/2009

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Directions to “ KELLEY H. AHR PSY.D” Practice Location

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