Provider Demographics
NPI:1184188732
Name:MOX, ALEXIS B
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:B
Last Name:MOX
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 1:44950 VISTA DUNES LN APT 54
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4198
Mailing Address - Country:US
Mailing Address - Phone:602-446-7012
Mailing Address - Fax:
Practice Address - Street 1:44950 VISTA DUNES LN APT 54
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-4198
Practice Address - Country:US
Practice Address - Phone:602-446-7012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst