Doctor Name: | MRS. MICHELLE LEE FOX |
NPI Number: | 1013245364 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LBP, CCRC |
License Number: | 0089 |
Business Practice Address: | 13071 Fairway Dr Choctaw, OK - 730208147 |
Business Phone Number: | 4057691613 |
Business Fax Number: | |
Mailing Address: | 13071 Fairway Dr, CHOCTAW |
State: | OK |
Postal Code: | 730208147 |
Phone Number: | 4057691613 |
Fax Number: | |
NPI Enumeration Date: | 11/25/2009 |
NPI Last Update Date: | 11/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0089 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |