Provider Demographics
NPI:1144564337
Name:WILLIAMS-TOLSTRUP, KATHY (MED)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:WILLIAMS-TOLSTRUP
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-1847
Mailing Address - Country:US
Mailing Address - Phone:970-391-8292
Mailing Address - Fax:
Practice Address - Street 1:420 S HOWES ST STE 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2871
Practice Address - Country:US
Practice Address - Phone:970-391-8292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health