Individual
THERESA TOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
602 PLEASANT OAK DR, OREGON, WI 53575-3282
(608) 835-5050
(608) 835-5010
Mailing address
602 PLEASANT OAK DR, OREGON, WI 53575-3282
(608) 835-5050
(608) 835-5010
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
673-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40954100
—
WI
01
—
673-124
LICEN MAR & FAM THERAPIST
WI
Enumeration date
05/15/2007
Last updated
07/08/2007
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