Individual
FALLON CHILDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2737 27TH ST APT 1G, ASTORIA, NY 11102-2424
(508) 922-9444
Mailing address
2737 27TH ST APT 1G, ASTORIA, NY 11102-2424
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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