Provider Demographics
NPI:1205914603
Name:FALCON, RAUL ALBERRTO (ED D)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:ALBERRTO
Last Name:FALCON
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 STATION RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3418
Mailing Address - Country:US
Mailing Address - Phone:413-256-1522
Mailing Address - Fax:
Practice Address - Street 1:33 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-1301
Practice Address - Country:US
Practice Address - Phone:413-846-4300
Practice Address - Fax:413-732-0429
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103TW0100X103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool