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General NPI Number Information
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NPI Number | 1194384164
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Entity Type | Individual
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Provider Name | CORRINE FALLON PSY. D
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Gender | Female
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Dates
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Enumeration Date | 06/12/2019
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Last Update Date | 06/12/2019
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Provider Practice Location Address
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Address Line | 140 PENNSYLVANIA AVE
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City | OAKMONT
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State | PA
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Zip | 15139-1923
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Country | US
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Telephone | 724-799-0262
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Fax |
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Provider Business Mailing Address
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Address Line | 212 SEANOR RD
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City | IRWIN
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State | PA
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Zip | 15642-9441
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Country | US
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Telephone | 724-799-0262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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