Individual
KATHLEEN COLE FALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS LCPC NCC
Contact information
Practice address
550 FOREST AVE, SUITE 200, PORTLAND, ME 04101-1505
(207) 370-0623
Mailing address
1414 FOREST AVE, UNIT 9, PORTLAND, ME 04103-1161
(207) 370-0623
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC2761
ME
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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