Provider Demographics
NPI:1245875053
Name:TOLLEFSON, JENNIFER AARSVOLD (PSYD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AARSVOLD
Last Name:TOLLEFSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 CONNECTICUT AVE NW STE 800
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1733
Mailing Address - Country:US
Mailing Address - Phone:202-986-5941
Mailing Address - Fax:
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1733
Practice Address - Country:US
Practice Address - Phone:202-986-5941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001548103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty