| Doctor Name: | DANIEL J FALLON |
| NPI Number: | 1467718411 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 000392 |
| Business Practice Address: | 19 Bassett St Suite 203 New Britain, CT - 060513034 |
| Business Phone Number: | 8603575532 |
| Business Fax Number: | 8603575538 |
| Mailing Address: | Po Box 162, NEW BRITAIN |
| State: | CT |
| Postal Code: | 060500162 |
| Phone Number: | 8603575532 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2012 |
| NPI Last Update Date: | 04/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 000392 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |