Provider Demographics
NPI:1326618513
Name:FALCONER, ELIZABETH (MA, BC-HIS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FALCONER
Suffix:
Gender:F
Credentials:MA, BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12528 ALCOTT ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-3850
Mailing Address - Country:US
Mailing Address - Phone:303-888-9065
Mailing Address - Fax:
Practice Address - Street 1:1200 S HOVER ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7902
Practice Address - Country:US
Practice Address - Phone:303-845-4216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHAD0000434237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist