Provider Demographics
NPI:1720454663
Name:FALTOT, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:FALTOT
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 1:1795 BEND RD
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:PA
Mailing Address - Zip Code:16137-2411
Mailing Address - Country:US
Mailing Address - Phone:724-866-1206
Mailing Address - Fax:724-983-1387
Practice Address - Street 1:272 E CONNELLY BLVD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-1852
Practice Address - Country:US
Practice Address - Phone:724-983-1131
Practice Address - Fax:724-983-1387
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC 008341101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional