Healthcare Provider Details

I. General information

NPI: 1033589056
Provider Name (Legal Business Name): MARKIE FALOTICO ED.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11850 CONREY RD
CINCINNATI OH
45249-1012
US

IV. Provider business mailing address

11850 CONREY RD
CINCINNATI OH
45249-1012
US

V. Phone/Fax

Practice location:
  • Phone: 513-864-2871
  • Fax:
Mailing address:
  • Phone: 513-864-2871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH3199277
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: