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NPI Code Detail

MEDICARE: ALLISON CHRISTINE WILLIAMS TOLLEFSON

MEDICARE: ALLISON CHRISTINE WILLIAMS TOLLEFSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist03517KS

General Provider Information

NPI Number : 1225961691
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON CHRISTINE WILLIAMS TOLLEFSON
Provider Business Mailing Address
First Line : 430 N WALNUT ST
Second Line :
City : AUGUSTA
State : KS
Zip : 67010-1036
Country : US
Telephone Number : 316-775-5491
Fax Number :
Provider Business Practice Location Address
First Line : 524 N MAIN ST
Second Line :
City : EL DORADO
State : KS
Zip : 67042-2024
Country : US
Telephone Number : 316-321-6036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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