Individual
TONJA MCCOLLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 DONALD AVE, INDEPENDENCE, KS 67301-2001
(620) 331-1748
Mailing address
PO BOX 688, INDEPENDENCE, KS 67301-0688
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW 6966
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200437450A
—
KS
Enumeration date
07/24/2007
Last updated
02/18/2013
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