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Individual
KELLY FALLON
Active
Individual
KELLY FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW-S, LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
254010
KY
1041C0700X
Clinical Social Worker
Primary
254010
KY
1041C0700X
Clinical Social Worker
I.1201146-SUPV
OH
Other
Enumeration date
03/18/2015
Last updated
12/18/2020
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