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General NPI Number Information
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NPI Number | 1386200434
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Entity Type | Individual
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Provider Name | KAYLYN AHRENDT LICSW
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Gender | Female
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 305 30TH AVE W
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City | ALEXANDRIA
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State | MN
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Zip | 56308-3429
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Country | US
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Telephone | 320-460-8028
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 54
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City | EAGLE BEND
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State | MN
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Zip | 56446-0054
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Country | US
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Telephone | 320-219-1689
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 22802
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License Number State | MN
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