Provider Demographics
NPI:1093242901
Name:COX, JACEY CASSANDRA (MS CF)
Entity Type:Individual
Prefix:MISS
First Name:JACEY
Middle Name:CASSANDRA
Last Name:COX
Suffix:
Gender:F
Credentials:MS CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 CARE WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8425
Mailing Address - Country:US
Mailing Address - Phone:540-371-7137
Mailing Address - Fax:
Practice Address - Street 1:1051 CARE WAY STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8425
Practice Address - Country:US
Practice Address - Phone:540-371-7137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008505235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist