Provider Demographics
NPI:1306060702
Name:RODES, KARIN HILSDALE (PHD, LAC)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:HILSDALE
Last Name:RODES
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:KARIN
Other - Middle Name:HANSON
Other - Last Name:HILSDALE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LAC
Mailing Address - Street 1:231 WEST DUVAL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614
Mailing Address - Country:US
Mailing Address - Phone:520-841-2448
Mailing Address - Fax:
Practice Address - Street 1:39580 S LAGO DEL ORO PKWY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-1091
Practice Address - Country:US
Practice Address - Phone:520-624-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0242171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist