Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1083031827 |
---|---|
Provider Name | Kimberly Fallon |
First Address | Batavia, NY 14020-9550 |
Second Address | Batavia, NY 14020-9550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2014 |
Last Update Date | 18/03/2014 |