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Organization
CORRINE FALLON LLC
Active
Organization
CORRINE FALLON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN FALLON (OWNER)
(724) 799-0262
Entity
Organization
Contact information
Practice address
212 SEANOR RD, IRWIN, PA 15642-9441
(724) 799-0262
Mailing address
212 SEANOR RD, IRWIN, PA 15642-9441
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
NULL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
NULL
103TP2701X
Group Psychotherapy Psychologist
—
—
103TS0200X
School Psychologist
—
NULL
103TS0200X
School Psychologist
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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