Performance Fallon INC

NPI #1851783187 in Prescott, Arizona

Provider Information

NPI Number: 1851783187
Entity Type: Organization
Organization Name: Performance Fallon INC
Primary Specialty: Psychologist - Clinical
Enumeration Date: Feb 24, 2015
Last Updated: Feb 24, 2015

Practice Location

Address: 143 E MERRITT ST
City: Prescott
State: Arizona
ZIP Code: 86301-2028
Phone: (928) 460-4443

Authorized Official

Name: DR. DANIEL T FALLON, PSY.D.
Title: PRESIDENT
Phone: (928) 460-4443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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