Provider Demographics
NPI:1497027841
Name:COX, JOSEPH M (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:COX
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 5TH ST S STE 204
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-2768
Mailing Address - Country:US
Mailing Address - Phone:218-331-0155
Mailing Address - Fax:218-331-0154
Practice Address - Street 1:200 5TH ST S STE 204
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2768
Practice Address - Country:US
Practice Address - Phone:218-331-0155
Practice Address - Fax:218-331-0154
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5621103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical