Provider Demographics
NPI:1346622925
Name:COLLINS, FALON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:FALON
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3189 TENNILLE HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:GA
Mailing Address - Zip Code:31035-7533
Mailing Address - Country:US
Mailing Address - Phone:770-268-0528
Mailing Address - Fax:706-535-3457
Practice Address - Street 1:1496 WOODFERN DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4531
Practice Address - Country:US
Practice Address - Phone:770-268-0528
Practice Address - Fax:706-535-3457
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010665235Z00000X
VA2202008378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist