Healthcare Provider Details

I. General information

NPI: 1568389609
Provider Name (Legal Business Name): KIMBERLY DAWN FALCHI HIS, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 SOUTHPARK BLVD
COLONIAL HEIGHTS VA
23834-3605
US

IV. Provider business mailing address

735 SOUTHPARK BLVD
COLONIAL HEIGHTS VA
23834-3605
US

V. Phone/Fax

Practice location:
  • Phone: 804-451-2060
  • Fax:
Mailing address:
  • Phone: 804-451-2060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2101001712
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: