Provider Demographics
NPI:1760638068
Name:TOLEN, WILLIAM CHRISTOPHER (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:TOLEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 N UNIVERSITY AVE
Mailing Address - Street 2:SUITE 300C
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4465
Mailing Address - Country:US
Mailing Address - Phone:801-716-0320
Mailing Address - Fax:801-406-0326
Practice Address - Street 1:3325 N UNIVERSITY AVE
Practice Address - Street 2:SUITE 300C
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4465
Practice Address - Country:US
Practice Address - Phone:801-716-0320
Practice Address - Fax:801-406-0326
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5878866-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical