Provider Demographics
NPI:1235712290
Name:FALLS, JONATHAN (BACHELOR OF SCIENCE)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:FALLS
Suffix:
Gender:M
Credentials:BACHELOR OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7403 DRAKE DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-7300
Mailing Address - Country:US
Mailing Address - Phone:540-718-1088
Mailing Address - Fax:
Practice Address - Street 1:7403 DRAKE DR
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-7300
Practice Address - Country:US
Practice Address - Phone:540-718-1088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician