Provider Demographics
NPI:1932592599
Name:KRISTEN FLUGSTAD PSYD, LLC
Entity Type:Organization
Organization Name:KRISTEN FLUGSTAD PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:DEANNE
Authorized Official - Last Name:FLUGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:928-774-0437
Mailing Address - Street 1:125 EAST ELM AVENUE #203
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001
Mailing Address - Country:US
Mailing Address - Phone:928-774-0437
Mailing Address - Fax:928-779-2191
Practice Address - Street 1:125 EAST ELM AVENUE #203
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001
Practice Address - Country:US
Practice Address - Phone:928-774-0437
Practice Address - Fax:928-779-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty