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NPI Code Detail

MEDICARE: MISS SANDRA ELLEN FALLON MS-CCC-SLP

MEDICARE:  MISS SANDRA ELLEN FALLON  MS-CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist05162MD

General Provider Information

NPI Number : 1265602908
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SANDRA ELLEN FALLON MS-CCC-SLP
Provider Business Mailing Address
First Line : 7205 RUTHERFORD RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21244-2711
Country : US
Telephone Number : 443-780-1417
Fax Number :
Provider Business Practice Location Address
First Line : 7205 RUTHERFORD RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21244-2711
Country : US
Telephone Number : 443-780-1417
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2008
Last Update Date : 03/10/2008

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Directions to “ MISS SANDRA ELLEN FALLON MS-CCC-SLP” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.