Provider Demographics
NPI:1457876799
Name:KARIN R. AHLSTRAND, PHD, PLLC
Entity Type:Organization
Organization Name:KARIN R. AHLSTRAND, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:AHLSTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-954-9930
Mailing Address - Street 1:5501 N SWAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5445
Mailing Address - Country:US
Mailing Address - Phone:152-024-3924
Mailing Address - Fax:520-342-0136
Practice Address - Street 1:5501 N SWAN RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5445
Practice Address - Country:US
Practice Address - Phone:152-024-3924
Practice Address - Fax:520-342-0136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3730103G00000X, 103T00000X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty