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General NPI Number Information
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NPI Number | 1932592599
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Entity Type | Organization
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Legal Business Name | KRISTEN FLUGSTAD PSYD, LLC
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 125 EAST ELM AVENUE #203
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City | FLAGSTAFF
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State | AZ
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Zip | 86001
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Country | US
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Telephone | 928-774-0437
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Fax | 928-779-2191
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Provider Business Mailing Address
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Address Line | 125 EAST ELM AVENUE #203
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City | FLAGSTAFF
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State | AZ
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Zip | 86001
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Country | US
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Telephone | 928-774-0437
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Fax | 928-779-2191
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Authorized Official
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Title or Position | PSYCHOLOGIST/MEMBER
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Name | DR. KRISTEN DEANNE FLUGSTAD
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Credential | PSYD
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Telephone | 928-774-0437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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