Provider Demographics
NPI:1023802501
Name:LUJAN, KATHRYN R
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:R
Last Name:LUJAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 N KOLB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4149
Mailing Address - Country:US
Mailing Address - Phone:520-505-2810
Mailing Address - Fax:602-581-3026
Practice Address - Street 1:2090 N KOLB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4149
Practice Address - Country:US
Practice Address - Phone:520-505-2810
Practice Address - Fax:602-581-3026
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician