Provider Information for 1043405053
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CHRISTINE FALLON LCSW
Sex: Female
NPI: 1043405053
Last Updated: 2023-10-17
Certification Date: 2023-10-17
Certification Date: 2023-10-17
Details
| Name | Value | ||||||||
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| NPI | 1043405053 | ||||||||
| Enumeration Date | 2007-09-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1222 ASH ST DANVILLE, PA 17821-1269 United States Phone: 570-274-6690 | Fax: | ||||||||
| Primary Practice Address | 1019 E WATER ST ELMIRA, NY 14901-3332 United States Phone: 607-733-5696 | Fax: | ||||||||
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