Provider Demographics
NPI:1568857209
Name:FALKNER, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FALKNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16249 CELTIC CIR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-6100
Mailing Address - Country:US
Mailing Address - Phone:815-791-6106
Mailing Address - Fax:
Practice Address - Street 1:16249 CELTIC CIR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:IL
Practice Address - Zip Code:60442-6100
Practice Address - Country:US
Practice Address - Phone:815-791-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist