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General NPI Number Information
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NPI Number | 1013234319
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Entity Type | Organization
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Legal Business Name | KRISTINE L FALCO PSYD PC
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 392 E MAIN AVE
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City | SISTERS
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State | OR
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Zip | 97759-0000
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Country | US
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Telephone | 541-480-4887
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1717
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City | SISTERS
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State | OR
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Zip | 97759-1717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. KRISTINE FALCO
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Credential |
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Telephone | 541-480-4887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 781
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License Number State | OR
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