MEDICARE: SHANNON KESSLER TOALSON

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
1	103T00000X	Psychologist	01549	KS

General Provider Information

NPI Number	:	1528427820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON KESSLER TOALSON

Provider Business Mailing Address
First Line	:	1201 WAKARUSA DR, E220
Second Line	:	E-220
City	:	LAWRENCE
State	:	KS
Zip	:	66049
Country	:	US
Telephone Number	:	785-553-9880
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 WAKARUSA DR, E220
Second Line	:	E-220
City	:	LAWRENCE
State	:	KS
Zip	:	66049
Country	:	US
Telephone Number	:	785-553-9880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	03/10/2026

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