# CORRINE FALLON LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295382380
- **Authorized official:** BEN FALLON (OWNER)
- **Authorized official phone:** (724) 799-0262

## Contact information

- **Practice address:** 212 SEANOR RD, IRWIN, PA 15642-9441
- **Practice address phone:** (724) 799-0262
- **Mailing address:** 212 SEANOR RD, IRWIN, PA 15642-9441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |
| 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