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NPI 1902047566

NPI 1902047566 : VINCENT FRANCIS FALLON M.A. : RENO, NV

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General NPI Number Information
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    NPI Number           |    1902047566
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    Entity Type          |    Individual 
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    Provider Name        |    VINCENT FRANCIS FALLON M.A.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/11/2009
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    Last Update Date     |    03/11/2009
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Provider Practice Location Address
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    Address Line         |    1090 S ROCK BLVD 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89502-7116
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    Country              |    US
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    Telephone            |    775-856-0353
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1090 S ROCK BLVD 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89502-7116
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    Country              |    US
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    Telephone            |    775-856-0353
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    R07070
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    License Number State |    NV
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