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NPI Code Detail

MEDICARE: DR. BRADD FALKENBERG PH.D.

MEDICARE: DR. BRADD FALKENBERG PH.D.
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
1103T00000XPsychologist5253OH
2103TS0200XSchool PsychologistOH1233979OH

General Provider Information

NPI Number : 1528482833
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADD FALKENBERG PH.D.
Provider Business Mailing Address
First Line : 65 STEINER AVE
Second Line :
City : AKRON
State : OH
Zip : 44301-1347
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 65 STEINER AVE
Second Line :
City : AKRON
State : OH
Zip : 44301-1347
Country : US
Telephone Number : 330-761-3065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2014
Last Update Date : 02/06/2014

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