Provider Demographics
NPI:1790337061
Name:FALKOWSKI, HEATHER ANN I
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:FALKOWSKI
Suffix:I
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 1:275 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2203
Mailing Address - Country:US
Mailing Address - Phone:330-615-7355
Mailing Address - Fax:
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2203
Practice Address - Country:US
Practice Address - Phone:330-615-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty