Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 6301007073 | MI |
N | 103T00000X | Psychologist | 6301007073 | MI |
Y | 103G00000X | Clinical Psychologist | 6301007073 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301007073 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301007073 | MI |
NPI | 1033305321 |
---|---|
Provider Name | Dr. David Vernon Falkner |
First Address | Ann Arbor, MI 48104-2156 |
Second Address | Ann Arbor, MI 48104-2156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2007 |
Last Update Date | 19/09/2007 |