Provider Demographics
NPI:1598275331
Name:FALCONER-HORNE, CAROLYN (MS)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:FALCONER-HORNE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BUXTON FARM RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:STANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-212-4191
Mailing Address - Fax:203-212-4191
Practice Address - Street 1:30 BUXTON FARM RD
Practice Address - Street 2:SUITE 230
Practice Address - City:STANFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-212-4191
Practice Address - Fax:203-212-4191
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT004942235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist