Provider Demographics
NPI:1164154514
Name:RAHN, KRISTJANA K (PSYD, LP)
Entity type:Individual
Prefix:
First Name:KRISTJANA
Middle Name:K
Last Name:RAHN
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SILVER LAKE RD NW STE 110
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1789
Mailing Address - Country:US
Mailing Address - Phone:844-697-8766
Mailing Address - Fax:920-416-8581
Practice Address - Street 1:2935 UNIVERSAL CT STE 2
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-6324
Practice Address - Country:US
Practice Address - Phone:844-697-8766
Practice Address - Fax:920-416-8581
Is Sole Proprietor?:No
Enumeration Date:2022-06-25
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC2200X
WI3738-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent