Provider Demographics
NPI:1962742114
Name:TOLLE, KATHRYN LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LOUISE
Last Name:TOLLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:LOUISE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:555 POYNTZ AVE
Mailing Address - Street 2:SUITE 243
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-0107
Mailing Address - Country:US
Mailing Address - Phone:785-537-6051
Mailing Address - Fax:844-222-3691
Practice Address - Street 1:555 POYNTZ AVE STE 243
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-0129
Practice Address - Country:US
Practice Address - Phone:785-537-6051
Practice Address - Fax:844-222-3691
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1990103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist