Provider Demographics
NPI:1679120729
Name:TOLMAN, KRISTEN E (ASUDC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:TOLMAN
Suffix:
Gender:F
Credentials:ASUDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S 200 E
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042-2047
Mailing Address - Country:US
Mailing Address - Phone:801-784-9455
Mailing Address - Fax:
Practice Address - Street 1:822 S 1040 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-4614
Practice Address - Country:US
Practice Address - Phone:801-609-2448
Practice Address - Fax:801-609-2447
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11290032-6019101YA0400X
UT11290032-6009101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)