Individual
MS. PEGGY E TOLLISON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW BCD
Contact information
Practice address
307 HIGH ST, MARYVILLE, TN 37804
(865) 681-2869
(865) 379-2869
Mailing address
307 HIGH ST, MARYVILLE, TN 37804
(865) 681-2869
(865) 379-2869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3319
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132681
TRICARE
TN
05
—
3921418
—
TN
Enumeration date
05/26/2006
Last updated
07/08/2007
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