Healthcare Provider Details

I. General information

NPI: 1063349413
Provider Name (Legal Business Name): KATHERINE AHRENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 19TH AVE SW
WILLMAR MN
56201-5274
US

IV. Provider business mailing address

23897 740TH AVE
RENVILLE MN
56284-2058
US

V. Phone/Fax

Practice location:
  • Phone: 320-403-5247
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: