Individual
GAHAN FALLONE
Active
Individual
GAHAN FALLONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LP
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2006004001
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669798575
—
MO
01
—
431560263
TRICARE
MO
01
—
P01089886
RR MCR
MO
Enumeration date
04/16/2010
Last updated
08/09/2022
Update your record
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