Provider Demographics
NPI:1518594498
Name:FOX, ANDREW RADIN (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RADIN
Last Name:FOX
Suffix:
Gender:M
Credentials:PHD, LP
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Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3525 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5275
Practice Address - Country:US
Practice Address - Phone:952-993-6200
Practice Address - Fax:952-993-5631
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-11-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNLP6840OtherMINNESOTA BOARD OF PSYCHOLOGY