Healthcare Provider Details

I. General information

NPI: 1457876799
Provider Name (Legal Business Name): KARIN R. AHLSTRAND, PHD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 N SWAN RD STE 100
TUCSON AZ
85718-5445
US

IV. Provider business mailing address

5501 N SWAN RD STE 100
TUCSON AZ
85718-5445
US

V. Phone/Fax

Practice location:
  • Phone: 152-024-3924
  • Fax: 520-342-0136
Mailing address:
  • Phone: 152-024-3924
  • Fax: 520-342-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3730
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number3730
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3730
License Number StateAZ

VIII. Authorized Official

Name: DR. KARIN R AHLSTRAND
Title or Position: CLINICAL NEUROPSYCHOLOGIST
Credential: PH.D.
Phone: 520-954-9930