Provider Demographics
NPI:1790578946
Name:FAULKNER, ALEXIA ANN MARIE
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:ANN MARIE
Last Name:FAULKNER
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 1:349 W MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1392
Mailing Address - Country:US
Mailing Address - Phone:507-337-2970
Mailing Address - Fax:
Practice Address - Street 1:349 W MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1392
Practice Address - Country:US
Practice Address - Phone:507-337-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician